BILL NUMBER: AB 1807 CHAPTERED
BILL TEXT
CHAPTER 74
FILED WITH SECRETARY OF STATE JULY 12, 2006
APPROVED BY GOVERNOR JULY 12, 2006
PASSED THE SENATE JUNE 27, 2006
PASSED THE ASSEMBLY JUNE 27, 2006
AMENDED IN SENATE JUNE 27, 2006
INTRODUCED BY Committee on Budget (Laird (Chair), Arambula,
Bermudez, Chan, Coto, De La Torre, Evans, Goldberg, Hancock,
Montanez, Mullin, Nava, Parra, Pavley, and Wolk)
JANUARY 10, 2006
An act to amend Section 1300 of the Business and Professions Code,
to amend Sections 1214, 1214.1, 1214.5, 1337.6, 1338.5, 1403,
1575.9, 1729, 1730, 1736.2, 1743.17, 1743.19, 1750, 1794.06, 100922,
103526, 103526.5, 107080, 111615, 111625, 115065, 115080, 117995,
118210, and 124977 of, to add Sections 1266.5, 1266.7, 1266.9,
1266.10, 1266.12, 1760.5, 101315.2, and 117971 to, to repeal Sections
1337.7, 1403.1, 1729.1, 1736.3, and 100445 of, and to repeal and add
Section 1266 of, the Health and Safety Code, to amend Sections
12693.70, 12696.05, and 12699 of, and to add Section 12695.03 to, the
Insurance Code, to amend Section 830.3 of the Penal Code, and to
amend Sections 4107, 4640.6, 4643, 4648.4, 4681.3, 4681.5, 4691.6,
4694, 4781.5, 4860, 5675.2, 14011.2, 14043.46, 14105.33, 14105.48,
14105.49, 14154, 14572, 14592, and 16809 of, and to add Sections
4690.5, 4691.8, 14007.2, 14067.3, 14068, and 14133.07 to, the Welfare
and Institutions Code, relating to health, making an appropriation
therefor, and declaring the urgency thereof, to take effect
immediately.
LEGISLATIVE COUNSEL'S DIGEST
AB 1807, Committee on Budget Health.
Existing law provides for the licensure and certification by the
State Department of Health Services of persons providing various
health services, including hemodialysis technicians. Existing law
provides that the certification and renewal fees for hemodialysis
technicians shall be $50.
This bill would delete the provision setting the certification and
renewal fees for hemodialysis technicians.
Existing law establishes provisions specifying the
responsibilities of the State Department of Health Services in the
implementation of various programs in the administration of public
health. Existing law provides for the licensure and regulation of
clinics and health facilities, as defined, and certain health care
providers.
This bill would provide that, unless otherwise specified in
statute, or unless funds are specifically appropriated from the
General Fund in the annual Budget Act or other enacted legislation,
the Licensing and Certification Division of the department shall, no
later than the beginning of the 2009-10 fiscal year, be supported
entirely by federal funds and special funds.
Existing law establishes specified licensing fees for various
clinics, health facilities, including hospitals, skilled nursing
facilities, congregate living facilities, intermediate care
facilities, and correctional treatment centers, and health care
providers, including referral agencies, adult day health care
agencies, home health agencies, private duty nursing agencies,
hospices, pediatric day health and respite care facilities, and home
dialysis agencies, and freestanding cardiac catheterization
laboratories.
Existing law requires each new and renewal application for a
license for specified health facilities to be accompanied by an
annual fee, as specified.
This bill would specify the licensing and certification program
fees applicable to various clinics, health care providers, and health
facilities, including the above clinics, health care providers, and
health facilities, for the 2006-07 fiscal year. The bill would
require the department, commencing February 1, 2007, and every
February 1 thereafter, to publish a list of estimated fees applicable
to those providers and facilities, and to adjust those fees as
specified. It would require the department to prepare and publish
specified reports relating to the licensing and certification of
those providers and facilities. The bill would provide for certain
late payment penalties when any of those entities continues to
operate beyond its license expiration date.
This bill would establish, within the Special Deposit Fund, the
State Department of Health Services Licensing and Certification
Program Account, and would specify that revenues collected for the
licensing of specified health care providers shall be deposited in
the account, for allocation, upon appropriation by the Legislature,
to support the department's licensing and certification program. It
would appropriate $3,204,370 from the General Fund to the department
for a loan for use in the support of the department's licensing and
certification program to be repaid from the proceeds of fees
collected for the licensing and certification of the above health
providers and facilities.
This bill would require the department, commencing January 1,
2007, to give priority in conducting initial licensing surveys to
each intermediate care facility/developmentally disabled,
intermediate care facility/developmentally disabled habilitative, and
intermediate care facility/developmentally disabled nursing.
Existing law establishes requirements, administered by the
department, for certification as a certified nurse assistant, and
imposes specified fees in connection with that certification.
This bill would repeal those fee provisions.
Existing law requires that a criminal record clearance shall be
conducted for all nurse assistants by the submission of fingerprint
cards to the department for processing at the Department of Justice,
and requires completion of the criminal record clearance prior to
issuance or renewal of a certificate. Existing law provides that the
fee to cover the processing costs of the Department of Justice shall
not exceed a specified amount.
This bill would require each health facility that operates and is
used as a clinical skills site for certification training, and each
health facility, prior to hiring a nurse assistant applicant
certified in another state or country, to arrange for and pay the
cost of the fingerprint live-scan service and the Department of
Justice processing costs for each applicant. The bill would prohibit
health facilities from passing these costs through to nurse assistant
applicants unless allowed by federal law.
Existing law regulates the licensing of home health agencies and
private duty nursing agencies, and certification of certified home
health aides. Existing law requires an application for renewal of a
home health agency license or a private duty nursing agency license
to be filed not less than 10 days prior to its expiration date.
This bill would require, instead, that the application for renewal
be filed not less than 30 days prior to its expiration date.
Existing law imposes various fees in connection with home health
aide certification.
This bill would repeal those fee provisions.
The bill would provide that, of certain funds appropriated in the
Budget Act of 2006 for local jurisdictions to prepare for public
health emergencies, a specified amount shall be provided to each
local jurisdiction first, with the remaining amount allocated based
on population.
Existing law, commencing July 1, 2007, prohibits local registrars
and county recorders from issuing an informational certified copy of
a birth or death certificate unless the source of the issuance is the
statewide database prepared by the State Registrar and specifies
that the security paper used for an informational certified copy of
those records shall also contain a statement in perforated type that
states it is informational and not a valid document to establish
identity.
This bill would apply the limitation to the issuance of those
records on July 1, 2007, but only after the statewide database
becomes operational and the information is entered into the database.
This bill would also extend the date on which the requirement for
the statement would be applied to January 1, 2009.
Existing law prohibits any person from manufacturing any drug or
device in the state unless he or she has a valid license from the
state and provides that the license is valid for one year from the
date of issue, unless it is revoked.
This bill would extend the period of the license to 2 years,
unless it is revoked.
Existing law provides for the regulation and licensing of persons
possessing radioactive materials and persons generally licensed for
the use of devices and equipment utilizing radioactive materials.
This bill would require the State Department of Health Services to
establish fees for followup inspections related to the failure to
correct violations of those regulations.
Existing law provides for the regulation of large quantity medical
waste generators and medical waste treatment facilities, including
the registration of, and the issuance of permits to, those medical
waste generators and treatment facilities. Existing law specifies the
annual fees that the department is required to collect for this
permit registration process.
This bill would require the department, in addition, to recover
its actual costs for services related to large quantity medical waste
generator followup inspections and enforcement activities necessary
to ensure compliance with these provisions.
The bill would authorize permits for medical waste treatment
facilities and large quantity medical waste generators to be issued
biennially.
Existing law specifies the annual fee for an offsite medical waste
treatment facility.
This bill would increase the amount of that fee, as specified.
Existing law requires the State Department of Health Services to
charge a fee for newborn screening and followup services, to be paid
to the Genetic Disease Testing Fund.
This bill would provide that the expenditure of funds from the
Genetic Disease Testing Fund for the expansion of the Genetic Disease
Branch Screening Information System to include cystic fibrosis and
biotinidase may be implemented through the amendment of the Genetic
Disease Branch Screening Information System contracts, and shall not
be subject to specified provisions of law governing public contracts
and information systems technology. It would provide that this
exemption shall also apply to the maintenance and operation of the
Genetic Disease Branch Screening Information System once the
expansion is implemented.
Existing law provides for various health programs under which
qualified low-income persons are provided health care services,
including the Healthy Families Program, which is administered by the
Managed Risk Medical Insurance Board. Existing law continuously
appropriates funds to the board from the Healthy Families Fund for
the program.
Under existing law, the Healthy Families Program includes a
purchasing pool providing health coverage for children in families
without affordable employer based dependent coverage. Existing law
provides that if an applicant for the purchasing pool does not have a
family contribution sponsor, the applicant shall pay the first month'
s family contribution and shall agree to remain in the program for 6
months.
This bill would make ineligible for the program, commencing July
1, 2007, an infant who is enrolled in employer-sponsored health
insurance or who is eligible for the full scope of Medi-Cal benefits
at no share of cost. This bill would also eliminate the first month
contribution requirement and apply the requirement to agree to stay
in the program for 6 months to any program applicant. By increasing
eligibility of a subscriber under the Healthy Families Program, this
bill would increase subscriber contributions and would result in an
appropriation.
Existing law, the Access to Infants and Mothers Program, is
administered by the Managed Risk Medical Insurance Board. Existing
law sets forth eligibility requirements for the program and permits
the board to determine subscriber amount schedules.
Existing law established the Perinatal Insurance Fund in the State
Treasury as a continuously appropriated fund to be used for the
purposes of the Access for Infants and Mothers Program and the
Healthy Families Fund, which is continuously appropriated to the
board for the purposes of funding the Healthy Families Program.
This bill would authorize the board to assess an additional
subscriber contribution, for 2 months, for subscribers enrolled on or
after July 1, 2007, with respect to an AIM-linked infant in the
Healthy Families Program, and would specify that the board shall
determine the portion of the subscriber contribution that shall be
transferred from the Perinatal Insurance Fund to the Healthy Families
Fund for payment of the Healthy Families Program premium for an
AIM-linked infant, as defined. By transferring funds to a
continuously appropriated fund, the bill would result in an
appropriation.
Existing law provides that certain specified persons are peace
officers, and includes all investigators of the State Department of
Developmental Services.
This bill would instead provide that the Chief, Deputy Chief,
supervising investigators, and investigators of the State Office of
Protective Services of the State Department of Developmental Services
are within the scope of that definition, provided that the primary
duty of each of those peace officers shall be the enforcement of the
law relating to the duties of his or her department or office.
Existing law provides that the State Department of Mental Health
shall house no more than 1,336 patients at Patton State Hospital,
with the exception that until one year after the activation of the
Coalinga Secure Treatment Facility, up to 1,670 patients may be
housed at the hospital.
This bill would instead, authorize the housing of up to 1,530
patients at the hospital in those circumstances until September 2009.
Existing law requires each regional center for persons with
developmental disabilities to provide service coordinator caseload
data to the State Department of Mental Health, as specified.
This bill would provide that, for purposes of calculating caseload
ratios for consumers enrolled in the Home- and Community-based
Services Waiver program, vacancies shall not be included in the
calculations.
Existing law provides for the assessment of certain individuals
for whom benefits are provided by regional centers for persons with
developmental disabilities. Existing law specifies that if assessment
is needed, prior to July 1, 2006, the assessment shall be performed
within 120 days following initial intake, and requires that
assessments after that date shall be performed within 60 days
following intake.
This bill would extend the 120-day assessment requirement until
July 1, 2007.
Under existing law, the State Department of Developmental Services
provides funding for regional centers for the provision of services
and supports to persons with developmental disabilities. Existing law
limits the rate of payment a regional center may pay a provider for
specified services to a rate that is in effect on or after June 30,
2004, with certain exceptions.
This bill would require that, as of July 1, 2006, rates for
specified services shall be increased by 3%, subject to funds
appropriated for this purpose in the Budget Act. The bill would, for
the 2006-07 fiscal year, except with respect to those services, limit
the rate of payment a regional center may pay a provider to a rate
that is in effect on or after July 1, 2006, except as provided.
The bill would increase the rate schedule in effect on June 30,
2006, for community care facilities serving persons with
developmental disabilities by 3% on July 1, 2006, subject to funds
specifically appropriated for this increase in the Budget Act of
2006.
Existing law provides that, during the 2005−06 fiscal year,
no regional center may approve any service level for a residential
service provider if the approval would result in an increase to be
paid to the provider that is greater than the rate in effect on or
after June 30, 2005.
This bill would make that limitation applicable with respect to
the 2006-07 fiscal year, and would base the limitation on the rate in
effect on or after July 1, 2006.
Existing law prohibits during the 2005−06 fiscal year, the
State Department of Developmental Services from establishing any
permanent payment rate for a community-based day program or in-home
respite care agency that has a temporary payment rate in effect on
June 30, 2005.
This bill would apply that prohibition to the 2006-07 fiscal year.
The bill would provide that, commencing July 1, 2006, the
community-based day program, work activity program, and in-home
respite service agency rate schedules authorized by the department
and in operation June 30, 2006, shall be increased by 3%, subject to
funds specifically appropriated for this increase in the Budget Act
of 2006.
The bill would, commencing July 1, 2006, increase the rate for
family member-provided respite services authorized by the department
and in operation June 30, 2006, by 3%, subject to funds specifically
appropriated for this increase in the Budget Act of 2006.
The bill would permit the department, to the extent funds are
appropriated in the annual Budget Act for this purpose, to provide a
rate increase for the purpose of enhancing wages for direct care
staff in day programs and in work activity programs, and in similar
programs, for individuals who are developmentally disabled that meet
any of specified criteria.
This bill would, commencing July 1, 2006, require certain regional
center vendors who are serving individuals enrolled under a
specified Home- and Community-based Services Waiver program for
persons with developmental disabilities to ensure that billing
information provided to regional centers identifies prescribed
information necessary to support billing under the waiver. It would
require regional centers to ensure that their contractual and other
billing and payment arrangements with providers require the provision
of any information necessary to support billing under the waiver.
Under existing law, the State Department of Developmental Services
provides funding for regional centers for the provision of services
and supports to persons with developmental disabilities. Existing law
provides that, for the 2005 -06 fiscal year, a regional center may
not expend any purchase of service funds for the startup of any new
program unless certain criteria are met, except as specified.
This bill would apply these provisions to the 2006-07 fiscal year.
The bill would revise the criteria for expending purchase of service
funds for the startup of a new program, and would add additional
criteria. The bill would create an exception from these provisions
for grants to current providers to engage in new or expanded
employment activities that result in greater integration, conversion
from sheltered to supported work environments, self-employment, and
increased consumer participation in the federal Ticket to Work
program.
This bill would increase the hourly rate, as prescribed, for
supported employment services provided to persons with developmental
disabilities receiving individualized and group services.
Existing law provides that any new or renewal licensure
application fees for psychiatric health facilities shall be collected
by the State Department of Mental Health.
This bill would create in the State Treasury the Licensing and
Certification Fund, Mental Health, from which moneys, upon
appropriation by the Legislature, shall be expended by the State
Department of Mental Health to fund administrative and other
activities in support of the Licensing and Certification Program
administered by the department.
Existing law provides for the Medi-Cal program, administered by
the State Department of Health Services, pursuant to which medical
benefits are provided to public assistance recipients and certain
other low-income persons. The Medi-Cal program is, in part, governed
and funded by federal Medicaid provisions.
Existing state and federal law requires every applicant or
beneficiary under the Medi-Cal program or, in the case of a child,
the child's caretaker relative or legal guardian on his or her
behalf, to declare, under penalty of perjury, that he or she is, or
is not, a citizen or national of the United States. Existing federal
law requires, as of July 1, 2006, that every person who declares to
be a citizen or national of the United States present satisfactory
documentary evidence of citizenship or nationality, as specified.
This bill would require an individual who declares to be a citizen
or national of the United States to present satisfactory documentary
evidence of citizenship or nationality in compliance with the above
provisions of federal law. The bill would provide that no services
shall be available under the Medi-Cal program for an individual who
fails to comply with these requirements, except as specified. The
bill would provide that, to the extent federal financial
participation is available, if an individual cooperates in the effort
to obtain and present the documentation required by these
provisions, the individual shall be given as much time as is allowed
by federal law and policy to present that documentation. The bill
would require counties to assist individuals to obtain the required
documentation, and would impose certain other duties on counties with
respect to these documentation requirements. By expanding the duties
of county agencies in administering eligibility requirements under
the Medi-Cal program, the bill would impose a state-mandated local
program.
Existing law provides that an immigrant who does not meet
specified requirements regarding his or her immigration status, and
who is otherwise eligible for Medi-Cal services, shall only be
eligible for certain emergency medical services, long-term care
services, and pregnancy-related services, except as specified.
This bill would provide that any individual who is otherwise
eligible for Medi-Cal services, but who does not meet the
documentation requirements described above, shall be eligible only
for the scope of services made available to immigrants under the
above provisions.
Existing law, the Adult Day Health Care Act, provides for the
licensure and regulation of adult day health care centers.
Existing law provides for the certification and enrollment of
adult day health care centers as Medi-Cal providers. Existing law
allows the State Department of Health Services to implement a
one-year moratorium on the certification and enrollment into the
Medi-Cal program of new adult day health care centers on a statewide
basis or within a geographic area, and allows the Director of Health
Services to extend this moratorium to coincide with a specified
waiver. Existing law creates certain exemptions from this
moratorium, including an exemption for an applicant for licensure and
certification that has been designated by a city and county which,
pursuant to a court order, is discharging certain persons from a
nursing facility to community housing.
This bill, commencing May 1, 2006, would revise this exemption and
would include additional conditions, as specified.
Existing law allows the State Department of Health Services to
enter into contracts with drug manufacturers for drugs from each
major therapeutic category, and requires it to maintain a list of
those drugs for which contracts have been executed. Existing law
requires these contracts to provide for an equalization payment
amount, as defined.
This bill would require that utilization data used to determine an
equalization payment amount include data from all programs that
qualify for federal drug rebates pursuant to specified provisions of
the federal Social Security Act, or that otherwise qualify for
federal funds under that act pursuant to the Medicaid state plan or
waivers.
Existing law requires the department to establish a list of
covered services and maximum allowable reimbursement rates for
durable medical equipment, as defined. Existing law requires that
reimbursement for all durable medical equipment billed to the
Medi-Cal program using codes with no specified maximum allowable rate
be the lesser of certain amounts, including the manufacturer's
suggested retail price, reduced by a percentage discount not to
exceed 20%.
This bill would base this amount, instead, on the manufacturer's
suggested retail purchase price on June 1, 2006, and documented by a
printed catalog or a hard copy of an electronic catalog page showing
the price on that date, reduced by a percentage discount not to
exceed 20%, or not to exceed 15% for wheelchairs and wheelchair
accessories if the provider employs or contracts with a qualified
rehabilitation professional, as defined. The bill would require,
commencing January 1, 2007, that reimbursement for oxygen delivery
systems and oxygen contents utilize certain national codes, and be
the lesser of specified amounts. The bill would require the
department, within a specified period, to review the utilization of
those services and equipment resulting from these changes, and to
notify the Joint Legislative Budget Committee if it finds an increase
in inappropriate use of those services or equipment.
Existing law requires the department to establish a list of
hearing aids and hearing aid accessories and determine the maximum
allowable product cost for each hearing aid product provided under
the Medi-Cal program, and requires that the list be published in
provider bulletins.
This bill would revise provisions governing maximum reimbursement
rates for hearing aids and hearing aid accessories, and would
authorize the department to implement those provisions by provider
manual or bulletin.
Existing law allows specified utilization controls, including
prior authorization, to be applied to covered Medi-Cal services that
are subject to utilization controls. Under existing law, outpatient
podiatric services are a covered benefit, subject to utilization
controls.
This bill would provide, commencing October 1, 2006, that prior
authorization for podiatric services provided on an outpatient or
inpatient basis shall not be required when specified conditions are
met.
Existing law requires the State Department of Health Services to
establish and maintain a plan whereby costs for county administration
of the determination of eligibility for benefits under the Medi-Cal
program will be effectively controlled within the amounts annually
appropriated for that administration. Existing law requires the plan
to establish standards and performance criteria.
This bill would state the intent of the Legislature to provide
appropriate funding to the counties for the effective administration
of the Medi-Cal program at the local level to ensure that counties
can reasonably meet the purposes of the performance measures as
contained in these provisions.
Existing law requires the State Department of Health Services, in
conjunction with the Managed Risk Medical Insurance Board, to develop
and conduct a community outreach and education campaign to help
families learn about, and apply for, the Medi-Cal program and the
Healthy Families Program.
This bill would allow the State Department of Health Services to
maintain an allocation program for the management and funding of
county outreach and enrollment plans to enroll and retain eligible
children in the Medi-Cal program and the Healthy Families Program.
The bill would require that a specified amount of the funds
appropriated for these purposes be set aside for counties meeting
certain criteria. It would require a county to submit an allocation
plan to obtain these funds.
Existing law allows the Director of Health Services to contract
with any qualified individual, organization, or entity to provide
Medi-Cal managed care services.
This bill would require that, in conducting outreach activities
for the enrollment of special needs populations into the Medi-Cal
managed care program, the State
Department of Health Services and its contractors, as deemed
applicable by the department, work with state, local, and regional
organizations with the ability to target low-income seniors and
individuals with disabilities in the communities where they live.
Existing law establishes the California Program of All-Inclusive
Care for the Elderly (PACE), to promote the development of
community-based, risk-based capitated long-term care programs.
Existing law allows the Director of Health Services to contract with
up to 10 demonstration projects to develop risk-based long-term care
pilot programs.
This bill would require the State Department of Health Services to
establish the monthly capitation fee paid to each PACE organization
at no less than a specified amount, subject to federal financial
participation.
Existing law prohibits Medi-Cal reimbursement from being made for
a service rendered by an adult day health care provider that does not
have a license as an adult day health care center or that does not
have currently effective Medi-Cal certification.
This bill would require that, notwithstanding this prohibition,
Medi-Cal certification be granted as of the date of licensure with
respect to, and reimbursement be made for, a service rendered on or
after that date if the provider meets specified requirements.
Existing law provides that the board of supervisors of a county
that contracted with the State Department of Health Services pursuant
to a specified provision of law during the 1990-91 fiscal year and
any county with a population under 300,000, as determined in
accordance with the 1990 decennial census, may, by adopting a
resolution to that effect, elect to participate in the County Medical
Services Program for state administration of health care services to
eligible persons in the county. Existing law revises, for the
2005-06 fiscal year, state and county financial responsibilities for
certain increases in the County Medical Services Program.
This bill would further extend that revision to include the
2006-07 fiscal year.
Existing law requires the State Department of Mental Health to
provide specified information to the appropriate fiscal and policy
committees of the Legislature regarding the operation of the
Metropolitan State Hospital.
This bill would require, in addition, commencing in September 2006
and every 3 months thereafter, that the department provide, pursuant
to a consent decree, specified information produced within the
previous 6 months by a court monitor, and certain other documents, to
those legislative committees, until the state is in compliance with
the consent decree.
This bill would refer an audit request to the Bureau of State
Audits to conduct an audit during the 2007-08 fiscal year of the
clinical laboratory oversight programs of the State Department of
Health Services to assess the department's practices and procedures
for enforcing state laws and regulations regarding the licensing,
certification, and registration of clinical laboratories. It would
provide that this audit request shall be considered by the Bureau of
State Audits within its overall audit requests, and would require
that the results of any audit conducted pursuant to these provisions
be reported to the chairs of specified committees of the Legislature.
This bill would allocate the amount of $24,803,000 in funds
appropriated in the Budget Act of 2006 from the Cigarette and Tobacco
Products Surtax Fund, and would specify the amount from which of
each account in the fund the appropriated funds shall be allocated.
The bill would specify the proportional allocation of those funds for
distribution by the California Healthcare for Indigents Program, the
rural health services program, and would limit the uses for which
those funds may be applied.
Existing federal law provides for the Early and Periodic
Screening, Diagnosis, and Treatment (EPSDT) program, under which
children covered by Medicaid receive specified health and mental
health services.
This bill would require the State Department of Mental Health to
revise its method for auditing entities that provide specialty mental
health services under the EPSDT program, and its method for
extrapolating data obtained from those audits, as specified.
Existing law requires that specified educational and related
services be provided to a child with a disability pursuant to an
individualized education plan. Existing law provides that the State
Department of Mental Health, or any community mental health service
designated by that department, is responsible for the provision of
mental health services to such a child, if required in the
individualized education program for the child.
This bill would require, commencing with the Budget Act of 2006,
that funds provided to county mental health department pursuant to
specified appropriations in the annual Budget Act be timely, and that
the funds be used exclusively to provide state-mandated services
pursuant to the above provisions. The bill would provide that the
State Department of Education shall be responsible for the timely
distribution to county offices of education of specified funds
appropriated in the Budget Act of 2006 for mental health services for
students with individualized education plans pursuant to the above
provisions, and would require that the timing of distributions meet
certain requirements. The bill would require that, commencing in the
2007-08 fiscal year, as a condition of receiving specified funds
appropriated in the Budget Act of 2006, a county mental health
department and the appropriate county office of education, or a
single entity designated by the county office of education, enter
into a memorandum of understanding. The bill would require the State
Department of Mental Health to develop a template of the memorandum
of understanding, containing specified elements, by October 1, 2006,
for use by county mental health departments and county offices of
education, and would require the memoranda of understanding to be
adopted by county mental health departments and county offices of
education by May 1, 2007. The bill would require the State Department
of Mental Health and the State Department of Education, by May 1,
2007, to collaboratively develop claiming instructions for the
appropriations for county mental health programs under these
provisions.
The bill would require the State Department of Health Services to
provide to the fiscal committees of the Legislature, by no later than
March 15, 2007, specified information regarding the reimbursement
rates paid under the Medi-Cal program, and would allow the department
to utilize up to a total of $600,000 of certain funds appropriated
in the Budget Act of 2006 for these purposes.
The bill would authorize the California Health and Human Services
Agency to implement a plan to improve the state's ability to respond
to a public health emergency, and would require the agency, in
consultation with the Office of Emergency Services, to report, on a
quarterly basis commencing October 1, 2006, to the appropriate fiscal
and policy committees of the Legislature, on the state's progress.
It would require the agency, by November 15, 2006, to provide to
those committees of the Legislature the state's plan for the new
health care delivery response system.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
This bill would declare that it is to take effect immediately as an
urgency statute.
Appropriation: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1300 of the Business and Professions Code is
amended to read:
1300. The amount of application, registration, and license fees
under this chapter shall be as follows:
(a) The application fee for a histocompatibility laboratory
director's, clinical laboratory bioanalyst's, clinical chemist's,
clinical microbiologist's, clinical laboratory toxicologist's,
clinical cytogeneticist's, or clinical molecular biologist's license
is thirty-eight dollars ($38). This fee shall be sixty-three dollars
($63) commencing on July 1, 1983.
(b) The annual renewal fee for a histocompatibility laboratory
director's, clinical laboratory bioanalyst's, clinical chemist's,
clinical microbiologist's, or clinical laboratory toxicologist's
license is thirty-eight dollars ($38). This fee shall be sixty-three
dollars ($63) commencing on July 1, 1983.
(c) The application fee for a clinical laboratory scientist's or
limited clinical laboratory scientist's license is twenty-three
dollars ($23). This fee shall be thirty-eight dollars ($38)
commencing on July 1, 1983.
(d) The application and annual renewal fee for a cytotechnologist'
s license shall be fifty dollars ($50) commencing on January 1, 1991.
(e) The annual renewal fee for a clinical laboratory scientist's
or limited clinical laboratory scientist's license is fifteen dollars
($15). This fee shall be twenty-five dollars ($25) commencing on
July 1, 1983.
(f) The application fee for a clinical laboratory license is six
hundred dollars ($600).
(g) The annual renewal fee for a clinical laboratory license is
five hundred fifty-seven dollars ($557).
(h) The application fee for a certificate of accreditation issued
pursuant to Section 1223 is one hundred fifty dollars ($150).
(i) The annual renewal fee for a certificate of accreditation
issued pursuant to Section 1223 is one hundred dollars ($100).
(j) In addition, clinical laboratories providing cytology services
shall pay an annual fee that shall be set by the department in an
amount needed to meet but not exceed the department's costs of
proficiency testing and special site surveys for these laboratories,
and that shall be based upon the volume of cytologic slides examined
by a laboratory. If the amount collected is less than or exceeds the
amount needed for these purposes, the amount of fees collected from
those laboratories in the following year shall be adjusted
accordingly.
(k) The application fee for a trainee's license is eight dollars
($8). This fee shall be thirteen dollars ($13) commencing on July 1,
1983.
(l) The annual renewal fee for a trainee's license is five dollars
($5). This fee shall be eight dollars ($8) commencing on July 1,
1983.
(m) The application fee for a duplicate license is three dollars
($3). This fee shall be five dollars ($5) commencing on July 1, 1983.
(n) The delinquency fee is equal to the annual renewal fee.
(o) The director may establish a fee for examinations required
under this chapter. The fee shall not exceed the total cost to the
department in conducting the examination.
(p) The annual fee for a clinical laboratory subject to
registration under paragraph (2) of subdivision (a) of Section 1265
and performing only those clinical laboratory tests or examinations
considered waived under CLIA is fifty dollars ($50). The annual fee
for a clinical laboratory subject to registration under paragraph (2)
of subdivision (a) of Section 1265 and performing only
provider-performed microscopy, as defined under CLIA is seventy-five
dollars ($75). A clinical laboratory performing both waived and
provider-performed microscopy shall pay an annual registration fee of
seventy-five dollars ($75).
(q) The costs of the department in conducting a complaint
investigation, imposing sanctions, or conducting a hearing under this
chapter shall be paid by the clinical laboratory. The fee shall be
no greater than the fee the laboratory would pay under CLIA for the
same type of activities and shall not be payable if the clinical
laboratory would not be required to pay those fees under CLIA.
(r) The state, a district, city, county, city and county, or other
political subdivision, or any public officer or body shall be
subject to the payment of fees established pursuant to this chapter
or regulations adopted thereunder.
(s) In addition to the payment of registration or licensure fees,
a clinical laboratory located outside the State of California shall
reimburse the department for travel and per diem to perform any
necessary onsite inspections at the clinical laboratory in order to
ensure compliance with this chapter.
(t) Whenever a clinical laboratory has paid registration or
compliance fees, or both, to HCFA under CLIA for the same period of
time for which a license is issued under Section 1265, the fee
required for the clinical laboratory license under subdivision (f) or
(g), and as adjusted pursuant to Section 100450 of the Health and
Safety Code, shall be reduced by the percentage of the total of all
CLIA registration and compliance fees paid to HCFA by all California
laboratories that are made available to the department to carry out
its functions as a CLIA agent in the federal fiscal year immediately
prior to when the license fee is due.
(u) The department shall establish an application fee and a
renewal fee for a medical laboratory technician license, the total
fees collected not to exceed the costs of the department for the
implementation and operation of the program licensing and regulating
medical laboratory technicians pursuant to Section 1260.3.
SEC. 2. Section 1214 of the Health and Safety Code is amended to
read:
1214. Each application under this chapter for an initial license,
renewal license, license upon change of ownership, or special permit
shall be accompanied by a Licensing and Certification Program fee,
as follows:
(a) For all primary care clinics licensed pursuant to this
chapter, the annual fee shall be set in accordance with Section 1266.
(b) For all specialty clinics licensed pursuant to this chapter,
the annual fee shall be set in accordance with Section 1266.
(c) For all rehabilitation clinics, the annual fee shall be set
in accordance with Section 1266.
SEC. 3. Section 1214.1 of the Health and Safety Code is amended to
read:
1214.1. Notwithstanding the provisions of Section 1214, each
application for a surgical clinic or a chronic dialysis clinic under
this chapter for an initial license, renewal license, license upon
change of ownership, or special permit shall be accompanied by an
annual Licensing and Certification Program fee set in accordance with
Section 1266.
SEC. 4. Section 1214.5 of the Health and Safety Code is amended to
read:
1214.5. Each application under this chapter for an initial
license, renewal license, license upon change of ownership, or
special permit for a psychology clinic shall be accompanied by a
Licensing and Certification Program fee set in accordance with
Section 1266.
SEC. 5. Section 1266 of the Health and Safety Code is repealed.
SEC. 6. Section 1266 is added to the Health and Safety Code, to
read:
1266. (a) Unless otherwise specified in statute, or unless funds
are specifically appropriated from the General Fund in the annual
Budget Act or other enacted legislation, the Licensing and
Certification Division shall, no later than the beginning of the
2009-10 fiscal year, be supported entirely by federal funds and
special funds.
(b) The Licensing and Certification Program fees for the 2006-07
fiscal year shall be as follows:
Type of Facility Fee
General Acute Care Hospitals $ 134.10 per bed
Acute Psychiatric Hospitals $ 134.10 per bed
Special Hospitals $ 134.10 per bed
Chemical Dependency Recovery
Hospitals $ 123.52 per bed
Skilled Nursing Facilities $ 202.96 per bed
Intermediate Care Facilities $ 202.96 per bed
Intermediate Care Facilities -
Developmentally Disabled $ 592.29 per bed
Intermediate Care Facilities -
Developmentally Disabled per
- Habilitative $1,000.00 facility
Intermediate Care Facilities -
Developmentally Disabled - per
Nursing $1,000.00 facility
Home Health Agencies per
$2,700.00 facility
Referral Agencies per
$5,537.71 facility
Adult Day Health Centers per
$4,650.02 facility
Congregate Living Health
Facilities $ 202.96 per bed
Psychology Clinics per
$ 600.00 facility
Primary Clinics - Community per
and Free $ 600.00 facility
Specialty Clinics - Rehab
Clinics per
(For profit) $2,974.43 facility
(Nonprofit) per
$ 500.00 facility
Specialty Clinics - Surgical per
and Chronic $1,500.00 facility
Dialysis Clinics per
$1,500.00 facility
Pediatric Day Health/Respite
Care $ 142.43 per bed
Alternative Birthing Centers per
$2,437.86 facility
Hospice per
$1,000.00 facility
Correctional Treatment Centers $ 590.39 per bed
(c) Commencing February 1, 2007, and every February 1 thereafter,
the department shall publish a list of estimated fees pursuant to
this section. The calculation of estimated fees and the publication
of the report and list of estimated fees shall not be subject to the
rulemaking requirements of Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code.
(d) By February 1 of each year, the department shall prepare the
following reports and shall make those reports, and the list of
estimated fees required to be published pursuant to subdivision (c),
available to the public by submitting them to the Legislature and
posting them on the department's Internet Web site:
(1) The department shall prepare a report of all costs for
activities of the Licensing and Certification Program. As part of
this report, the department shall recommend Licensing and
Certification Program fees in accordance with the following:
(A) Projected workload and costs shall be grouped for each fee
category.
(B) Cost estimates, and the estimated fees, shall be based on the
appropriation amounts in the Governor's proposed budget for the next
fiscal year, with and without policy adjustments to the fee
methodology.
(C) The allocation of program, operational, and administrative
overhead, and indirect costs to fee categories shall be based on
generally accepted cost allocation methods. Significant items of
costs shall be directly charged to fee categories if the expenses can
be reasonably identified to the fee category that caused them.
Indirect and overhead costs shall be allocated to all fee categories
using a generally accepted cost allocation method.
(D) The amount of federal funds and General Fund moneys to be
received in the budget year shall be estimated and allocated to each
fee category based upon an appropriate metric.
(E) The fee for each category will be determined by dividing the
aggregate state share of all costs for the Licensing and
Certification Program by the appropriate metric for the category of
licensure.
(2) (A) The department shall prepare a staffing and systems
analysis to ensure efficient and effective utilization of fees
collected, proper allocation of departmental resources to licensing
and certification activities, survey schedules, complaint
investigations, enforcement and appeal activities, data collection
and dissemination, surveyor training, and policy development.
(B) The analysis under this paragraph shall be made available to
interested persons and shall include all of the following:
(i) The number of surveyors and administrative support personnel
devoted to the licensing and certification of health care facilities.
(ii) The percentage of time devoted to licensing and certification
activities for the various types of health facilities.
(iii) The number of facilities receiving full surveys and the
frequency and number of follow up visits.
(iv) The number and timeliness of complaint investigations.
(v) Data on deficiencies and citations issued, and numbers of
citation review conferences and arbitration hearings.
(vi) Other applicable activities of the licensing and
certification division.
(e) (1) The department shall adjust the list of estimated fees
published pursuant to subdivision (c) if the annual Budget Act or
other enacted legislation includes an appropriation that differs from
those proposed in the Governor's proposed budget for that fiscal
year.
(2) The department shall publish a final fee list, with an
explanation of any adjustment, by the issuance of an all facilities
letter, by posting the list on the department's Internet Web site,
and by including the final fee list as part of the licensing
application package, within 14 days of the enactment of the annual
Budget Act. The adjustment of fees and the publication of the final
fee list shall not be subject to the rulemaking requirements of
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code.
(f) (1) No fees shall be assessed or collected pursuant to this
section from any state department, authority, bureau, commission, or
officer, unless federal financial participation would become
available by doing so and an appropriation is included in the annual
Budget Act for that state department, authority, bureau, commission,
or officer for this purpose. No fees shall be assessed or collected
pursuant to this section from any clinic that is certified only by
the federal government and is exempt from licensure under Section
1206, unless federal financial participation would become available
by doing so.
(2) For the 2006-07 state fiscal year, no fee shall be assessed or
collected pursuant to this section from any general acute care
hospital owned by a health care district with 100 beds or less.
(g) The Licensing and Certification Program may change annual
license expiration renewal dates to provide for efficiencies in
operational processes or to provide for sufficient cash flow to pay
for expenditures. If an annual license expiration date is changed,
the renewal fee shall be prorated accordingly. Facilities shall be
provided with a 60-day notice of any change in their annual license
renewal date.
SEC. 7. Section 1266.5 is added to the Health and Safety Code, to
read:
1266.5. (a) Whenever any entity required to pay fees pursuant to
Section 1266 continues to operate beyond its license expiration date,
without the Licensing and Certification Program renewal fees first
having been paid as required by this division, those fees are
delinquent.
(b) A late payment penalty shall be added to any delinquent fees
due with an application for license renewal made later than midnight
of the license expiration date. The late payment penalty shall be
computed as follows:
(1) For a delinquency period of 30 days or less, the penalty shall
be 10 percent of the fee.
(2) For a delinquency period of more than 30 days to and including
60 days, the penalty shall be 20 percent of the fee.
(3) For a delinquency period of more than 60 days, the penalty
shall be 60 percent of the fee.
(c) The department may, upon written notification to the licensee,
offset any moneys owed to the licensee by the Medi-Cal program or
any other payment program administered by the department, to recoup
the license renewal fee and any associated late payment penalties.
(d) No license may be renewed without payment of the Licensing and
Certification Program fee plus any late payment penalty.
SEC. 8. Section 1266.7 is added to the Health and Safety Code, to
read:
1266.7. The annual Licensing and Certification Program fee for a
congregate living health facility shall be set in accordance with
Section 1266.
SEC. 9. Section 1266.9 is added to the Health and Safety Code, to
read:
1266.9. There is established within the Special Deposit Fund the
Department of Health Services, Licensing and Certification Program
Account. The revenue collected in accordance with Section 1266 shall
be deposited in the Licensing and Certification Program Account and
shall be available for expenditure upon appropriation to support the
Licensing and Certification Program's operation. Interest earned on
the funds in the Licensing and Certification Program Account shall be
deposited as revenue into the Account to support the Licensing and
Certification Program's operation.
SEC. 10. Section 1266.10 is added to the Health and Safety Code,
to read:
1266.10. The amount of three million two hundred four thousand
three hundred seventy dollars ($3,204,370) is appropriated from the
General Fund to the State Department of Health Services, for a loan
for use to support the operations of the Licensing and Certification
Program. Repayment of this loan shall be made with proceeds from fees
collected pursuant to Section 1266, in three equal annual
installments of one million sixty-eight thousand one hundred
twenty-three dollars ($1,068,123), commencing on July 1, 2007, or
upon the enactment of the Budget Act of 2007, whichever is later.
SEC. 11. Section 1266.12 is added to the Health and Safety Code,
to read:
1266.12. (a) The annual Licensing and Certification Program fee
for a skilled nursing facility, intermediate care facility, general
acute care hospital, acute psychiatric hospital, special hospital,
chemical dependency recovery hospital, correctional treatment center,
intermediate care facility/developmentally disabled, intermediate
care facility/developmentally disabled nursing, and intermediate care
facility/developmentally disabled habilitative shall be set in
accordance with Section 1266.
(b) Commencing January 1, 2007, the department shall give priority
in conducting initial licensing surveys to each intermediate care
facility/developmentally disabled, intermediate care
facility/developmentally disabled habilitative, and intermediate care
facility/developmentally disabled nursing. Upon successful
completion of licensure, and upon notification by the facility that
it is ready for an initial certification survey, the department shall
schedule and initiate a certification survey within 60 days.
SEC. 12. Section 1337.6 of the Health and Safety Code is amended
to read:
1337.6. (a) Certificates issued under this article shall be
renewed every two years and renewal shall be conditional upon the
occurrence of all of the following:
(1) The certificate holder submitting documentation of completion
of 48 hours of in-service training every two years obtained through
an approved training program or taught by a director of staff
development for a licensed skilled nursing or intermediate care
facility that has been approved by the department, or by individuals
or programs approved by the department. At least 12 of the 48 hours
of in-service training shall be completed in each of the two years.
Twenty-four of the 48 hours of in-service training may be obtained
through an online computer training program approved by the Licensing
and Certification Division of the department.
(2) (A) A vendor of online programs for continuing education shall
ensure that each online course contains all of the following:
(i) An interactive portion where the participants receive
feedback, through online communication, based on input from the
participant.
(ii) Required use of a personal identification number or personal
identification information to confirm the identity of the
participant.
(iii) A final screen displaying a printable statement, to be
signed by the participant, certifying that the identified participant
completed the course. The vendor shall obtain a copy of the final
screen statement with the original signature of the participant prior
to the issuance of a certificate of completion. The signed statement
of completion shall be maintained by the vendor for a period of
three years and shall be made available to the department upon
demand.
(B) The department may approve online programs for continuing
education that do not meet the requirements of subparagraph (A) if
the vendor demonstrates to the department's satisfaction that,
through advanced technology, the course and the course delivery meet
the other requirements of this section.
(3) The certificate holder obtaining a criminal record clearance.
(b) Certificates issued under this article shall expire on the
certificate holder's birthday.
(c) To renew an unexpired certificate, the certificate holder
shall, on or before the certificate expiration date, apply for
renewal on a form provided by the department and submit documentation
of the required in-service training.
(d) The department shall give written notice to a certificate
holder 90 days in advance of the renewal date and, 90 days in advance
of the expiration of the fourth year that a renewal application has
not been submitted, and shall give written notice informing the
certificate holder, in general terms, of the provisions of this
article. Nonreceipt of the renewal notice does not relieve the
certificate holder of the obligation to make a timely renewal.
Failure to make a timely renewal shall result in expiration of the
certificate.
(e) Except as otherwise provided in this article, an expired
certificate may be renewed at any time within two years after its
expiration on the filing of an application for renewal on a form
prescribed by the department and documentation of the required
in-service education.
Renewal under this article shall be effective on the date on which
the application is filed. If so renewed, the certificate shall
continue in effect until the date provided for in this article, when
it shall expire if it is not again renewed.
(f) If a certified nurse assistant applies for renewal more than
two years after the expiration, the certified nurse assistant shall
complete an approved 75-hour competency evaluation training program
and competency evaluation program. A suspended certificate is subject
to expiration and shall be renewed as provided in this article, but
this renewal does not entitle the certificate holder, while the
certificate remains suspended, and, until it is reinstated, to engage
in the certified activity, or in any other activity or conduct in
violation of the order or judgment by which the certificate was
suspended.
(g) A revoked certificate is subject to expiration as provided in
this article, but it cannot be renewed.
(h) Except as provided in subdivision (i), a certificate that is
not renewed within four years after its expiration cannot be renewed,
restored, reissued, or reinstated except upon completion of a
certification program unless deemed otherwise by the department if
both of the following conditions are met:
(1) No fact, circumstance, or condition exists that, if the
certificate was issued, would justify its revocation or suspension.
(2) The person takes and passes any examination that may be
required of an applicant for a new certificate at that time, that
shall be given by an approved provider of a certification training
program.
(i) A certified nurse assistant whose certificate has expired
after two years may have his or her certificate renewed if he or she
completes 75 hours in an approved competency evaluation training
program, passes a competency test, and obtains a criminal background
clearance prior to the renewal. The department shall develop a
training program for these previously certified individuals.
(j) Certificate holders shall notify the department within 60 days
of any change of address. Any notice sent by the department shall be
effective if mailed to the current address filed with the
department.
(k) Certificate holders that have been certified as both nurse
assistants pursuant to this article and home health aides pursuant to
Chapter 8 (commencing with Section 1725) of Division 2 shall renew
their certificates at the same time on one application.
SEC. 13. Section 1337.7 of the Health and Safety Code is repealed.
SEC. 14. Section 1338.5 of the Health and Safety Code is amended
to read:
1338.5. (a) (1) A criminal record clearance shall be conducted
for all nurse assistants by the submission of fingerprint cards to
the state department for processing at the Department of Justice.
This criminal record clearance shall be completed prior to issuing or
renewing a certificate. The fee to cover the processing costs of the
Department of Justice, not including the costs associated with
rolling the fingerprint cards, shall not exceed thirty-two dollars
($32) per card.
(2) Upon enrollment in a training program for nurse assistant
certification, and prior to direct contact with residents, a
candidate for training shall submit a training and examination
application and the fingerprint cards to the state department to
receive a criminal record review through the Department of Justice.
Submission of the fingerprints to the Federal Bureau of Investigation
shall be at the discretion of the state department.
(3) Each health facility that operates and is used as a clinical
skills site for certification training, and each health facility,
prior to hiring a nurse assistant applicant certified in another
state or country, shall arrange for and pay the cost of the
fingerprint live-scan service and the Department of Justice
processing costs for each applicant. Health facilities may not pass
these costs through to nurse assistant applicants unless allowed by
federal law enacted subsequent to the effective date of this
paragraph.
(b) Upon receipt of the fingerprints, the Department of Justice
shall notify the state department of the criminal record information,
as provided for in this subdivision. If no criminal record
information has been recorded, the Department of Justice shall
provide the state department with a statement of that fact. If the
fingerprints are illegible, the Department of Justice shall, within
15 calendar days from
receipt of the fingerprints, notify the state department of that
fact.
(c) The department shall respond to the applicant and employer
within 30 days from the date of receipt of the fingerprint cards.
(d) The use of fingerprint live-scan technology implemented by the
Department of Justice by the year 1999 shall be used by the
Department of Justice to generate timely and accurate positive
fingerprint identification prior to nurse assistant certification.
(e) The state department shall develop procedures to ensure that
any licensee, direct care staff, or certificate holder for whom a
criminal record has been obtained pursuant to this section or Section
1265.5 or 1736 shall not be required to obtain multiple criminal
record clearances.
(f) If the department receives a fingerprint card from a certified
nursing assistant 60 days prior to the expiration of the certified
nursing assistant's certification and the department has received no
response from the Department of Justice, or if the department is
experiencing a delay in processing the renewal of the certified
nursing assistant's certification at the time of the expiration of
the certified nursing assistant's certification, the department may
extend the expiration of the certified nursing assistant's
certification for 60 days. This provision shall expire August 1,
2001.
SEC. 15. Section 1403 of the Health and Safety Code is amended to
read:
1403. Each application for a license or renewal of license under
this chapter shall be accompanied by an annual Licensing and
Certification Program fee set in accordance with Section 1266. Each
license shall expire 12 months from its date of issuance and
application for renewal accompanied by the fee shall be filed with
the director not later than 30 days prior to the date of expiration.
SEC. 16. Section 1403.1 of the Health and Safety Code is repealed.
SEC. 17. Section 1575.9 of the Health and Safety Code is amended
to read:
1575.9. Each application for a new license or renewal submitted
to the state department shall be accompanied by an annual Licensing
and Certification Program fee set in accordance with Section 1266.
SEC. 18. Section 1729 of the Health and Safety Code is amended to
read:
1729. Each application for a license under this chapter, except
applications by the State of California or any state department,
authority, bureau, commission, or officer, shall be accompanied by a
Licensing and Certification Program fee for the headquarters or main
office of the agency and for each additional branch office maintained
and operated by the agency in the amount set in accordance with
Section 1266.
SEC. 19. Section 1729.1 of the Health and Safety Code is repealed.
SEC. 20. Section 1730 of the Health and Safety Code is amended to
read:
1730. Each license issued under this chapter shall expire 12
months from the date of its issuance. Application for renewal of
license accompanied by the necessary fee shall be filed with the
state department annually, not less than 30 days prior to expiration
date. Failure to make a timely renewal shall result in expiration of
the license.
SEC. 21. Section 1736.2 of the Health and Safety Code is amended
to read:
1736.2. (a) Certificates issued for certified home health aides
shall be renewed every two years and renewal shall be conditioned on
the certificate holder obtaining a criminal record clearance pursuant
to Section 1736.6.
(b) Certificates issued to certified home health aides shall
expire on the certificate holder's birthday.
(c) To renew an unexpired certificate, the certificate holder
shall, on or before the certificate expiration date, apply for
renewal on a form provided by the state.
(d) The department shall give written notice to a certificate
holder 90 days in advance of the renewal date and 90 days in advance
of the expiration of the fourth year that an application has not been
submitted, and shall give written notice informing the certificate
holder in general terms of the provisions governing certificate
renewal for certified home health aides. Nonreceipt of the renewal
notice does not relieve the certificate holder of the obligation to
make a timely renewal. Failure to make a timely renewal shall result
in expiration of the certificate.
(e) Except as otherwise provided in this article, an expired
certificate may be renewed at any time within four years after its
expiration on the filing of an application for renewal on a form
prescribed by the department.
Renewal under this article shall be effective on the date on which
the application is filed. If renewed, the certificate shall continue
in effect until the date provided for in this section, when it shall
expire if it is not again renewed.
(f) If a certified home health aide applies for renewal more than
30 days after expiration but within four years after the expiration,
and demonstrates in writing to the department's satisfaction why the
renewal application was late, then the state department shall issue a
renewal. A suspended certificate is subject to expiration and shall
be renewed as provided in this article, but this renewal does not
entitle the certificate holder, while the certificate remains
suspended, and until it is reinstated, to engage in the certified
activity, or in any other activity or conduct in violation of the
order or judgment by which the certificate was suspended.
(g) A revoked certificate is subject to expiration as provided in
this section, but it cannot be renewed.
(h) A certificate that is not renewed within four years after its
expiration cannot be renewed, restored, reissued, or reinstated
except upon completion of a certification training program unless
deemed otherwise by the state department if both of the following
conditions are met:
(1) No fact, circumstance, or condition exists that, if the
certificate were issued, would justify its revocation or suspension.
(2) The person takes and passes any examination that may be
required of an applicant for a new certificate at that time, that
shall be given by an approved provider of a certification training
program.
(i) Certificate holders shall notify the department within 60 days
of any change of address. Any notice sent by the department shall be
effective if mailed to the current address filed with the
department.
(j) Certificate holders that have been certified as both nurse
assistants pursuant to Article 9 (commencing with Section 1337) of
Chapter 2 of Division 2 and home health aides pursuant to this
chapter shall renew their certificates at the same time on one
application.
SEC. 22. Section 1736.3 of the Health and Safety Code is repealed.
SEC. 23. Section 1743.17 of the Health and Safety Code is amended
to read:
1743.17. Each application for a private duty nursing agency
license under this chapter, except applications by this state or any
state department, authority, bureau, commission, or officer, shall be
accompanied by a Licensing and Certification Program fee for the
headquarters or main office of the agency and for each additional
branch office maintained and operated by the agency in the amount set
in accordance with Section 1266.
SEC. 24. Section 1743.19 of the Health and Safety Code is amended
to read:
1743.19. Each private duty nursing agency license issued under
this chapter shall expire 12 months from the date of its issuance.
Application for renewal of license accompanied by the necessary fee
shall be filed with the department annually, not less than 30 days
prior to expiration date. Failure to make a timely renewal shall
result in expiration of the license.
SEC. 25. Section 1750 of the Health and Safety Code is amended to
read:
1750. (a) Each new and renewal application for a license under
this chapter shall be accompanied by an annual Licensing and
Certification Program fee set in accordance with Section 1266.
(b) All hospices shall maintain compliance with the licensing
requirements. These requirements shall not, however, prohibit the use
of alternate concepts, methods, procedures, techniques, space,
equipment, personnel qualifications, or the conducting of pilot
projects, necessary for program flexibility. Program flexibility
shall be carried out with provision for safe and adequate patient
care and with prior written approval of the state department. A
written request for program flexibility and substantiating evidence
supporting the request shall be submitted by the applicant or
licensee to the state department. The state department shall approve
or deny the request within 60 days of submission. Approval shall be
in writing and shall provide for the terms and conditions under which
program flexibility is approved. A denial shall be in writing and
shall specify the basis therefor. If after investigation the state
department determines that a hospice using program flexibility
pursuant to this section is operating in a manner contrary to the
terms or conditions of the approval for program flexibility, the
director shall immediately revoke that approval.
(c) Each hospice shall, on or before March 15 of each year, file
with the Office of Statewide Health Planning and Development (OSHPD),
upon forms furnished by OSHPD, a verified report for the preceding
calendar year upon all matters requested by OSHPD. This report may
include, but not be limited to, data pertaining to age of patients,
diagnostic categories of patients, and number of visits by service
provided.
SEC. 26. Section 1760.5 is added to the Health and Safety Code, to
read:
1760.5. The annual Licensing and Certification Program fee for a
pediatric day health and respite care facility, as defined in Section
1760.2, shall be set in accordance with Section 1266.
SEC. 27. Section 1794.06 of the Health and Safety Code is amended
to read:
1794.06. Each application for a license under this chapter shall
be accompanied by a Licensing and Certification Program fee set in
accordance with Section 1266.
SEC. 28. Section 100445 of the Health and Safety Code is repealed.
SEC. 29. Section 100922 of the Health and Safety Code is amended
to read:
100922. (a) Notwithstanding any other provision of law, a
freestanding cardiac catheterization laboratory that as of December
31, 1993, was in active status in the Health Care Pilot Project
established pursuant to former Part 1.85 (commencing with Section
444) of Division 1, and that meets the requirements specified in this
section, may be licensed by the State Department of Health Services
as a freestanding cardiac catheterization laboratory. The license
shall be subject to suspension or revocation, or both, in accordance
with Article 5 (commencing with Section 1240) of Chapter 1 of
Division 2. An application for licensure or annual renewal shall be
accompanied by a Licensing and Certification Program fee set in
accordance with Section 1266.
(b) A laboratory granted a license pursuant to this section shall
be subject to the department's regulations that govern cardiac
catheterization laboratories operating in hospitals without
facilities for cardiac surgery, any similar regulations that may be
developed by the department specifically to govern freestanding
cardiac catheterization laboratories, and to the following
regulations: subdivisions (a) and (d) of Section 70129 of; paragraphs
(1), (2), (3), and (4) of subdivision (a) of, and subdivision (i) of
Section 70433 of; paragraphs (1), (3), (4), and (5) of subdivision
(a) of Section 70435 of; subparagraphs (A), (B), and (D) of paragraph
(1) of, and paragraphs (5) and (7) of, subdivision (b) of Section
70437 of; subdivision (a) of Section 70439 of; Sections 70841, 75021,
and 75022 of; subdivision (a) of Section 75023 of; Sections 75024,
75025, and 75026 of; subdivisions (a), (b), and (c) of Section 75027
of; subdivision (b) of Section 75029 of; Section 75030 of;
subdivision (b) of Section 75031 of; Sections 75034, 75035, 75037,
75039, 75045, and 75046 of; subdivision (a) of Section 75047 of; and
Sections 75050, 75051, 75052, 75053, 75054, 75055, 75057, 75059,
75060, 75061, 75062, 75063, 75064, 75065, 75066, 75071, and 75072 of;
Title 22 of the California Code of Regulations.
(c) A laboratory granted a license pursuant to this section shall
have a system for the ongoing evaluation of its operations and the
services it provides. This system shall include a written plan for
evaluating the efficiency and effectiveness of the health care
services provided that describes the following:
(1) The scope of the services provided.
(2) Measurement indicators regarding the processes and outcomes of
the services provided.
(3) The assignment of responsibility when the data from the
measurement indicators demonstrates the need for action.
(4) A mechanism to ensure followup evaluation of the effectiveness
of the actions taken.
(5) An annual evaluation of the plan.
(d) A laboratory granted a license pursuant to this section is
authorized to perform only the following diagnostic procedures:
(1) Right heart catheterization or angiography, or both.
(2) Left heart catheterization or angiography, or both.
(3) Coronary catheterization and angiography.
(4) Electrophysiology studies.
(e) A laboratory granted a license pursuant to this section shall
only perform its procedures on adults, on an outpatient basis. Each
laboratory shall define patient characteristics that are appropriate
for safe performance of procedures in the laboratory, and include
evaluation of these criteria in its quality assurance process.
(f) Notwithstanding the requirements already set forth in this
chapter, freestanding cardiac catheterization laboratories shall
comply with all other applicable federal, state, and local laws.
(g) This section shall become operative on January 1, 1995, and
does not require the department to adopt regulations.
SEC. 30. Section 101315.2 is added to the Health and Safety Code,
to read:
101315.2. Of the sixteen million dollars ($16,000,000)
appropriated in the Budget Act of 2006 for local health jurisdictions
for the purpose of preparing California for public health
emergencies, including a potential pandemic influenza event, a
baseline allocation of one hundred twenty-five thousand dollars
($125,000) shall be provided to each local health jurisdiction first,
with the remaining amount allocated on a per population basis using
the population information possessed by the Department of Finance.
SEC. 31. Section 103526 of the Health and Safety Code is amended
to read:
103526. (a) If the State Registrar, local registrar, or county
recorder receives a written or faxed request for a certified copy of
a birth or death record pursuant to Section 103525, or a military
service record pursuant to Section 6107 of the Government Code, that
is accompanied by a notarized statement sworn under penalty of
perjury, or a faxed copy of a notarized statement sworn under penalty
of perjury, that the requester is an authorized person, as defined
in this section, that official may furnish a certified copy to the
applicant in accordance with Section 103525 and in accordance with
Section 6107 of the Government Code. If a written request for a
certified copy of a military service record is submitted to a county
recorder by fax, the county recorder may furnish a certified copy of
the military record to the applicant in accordance with Section
103525. A faxed notary acknowledgment accompanying a faxed request
received pursuant to this subdivision for a certified copy of a birth
or death record or a military service record shall be legible and,
if the notary's seal is not photographically reproducible, show the
name of the notary, the county of the notary's principal place of
business, the notary's telephone number, the notary's registration
number, and the notary's commission expiration date typed or printed
in a manner that is photographically reproducible below, or
immediately adjacent to, the notary's signature in the
acknowledgment. If a request for a certified copy of a birth or death
record is made in person, the official shall take a statement sworn
under penalty of perjury that the requester is signing his or her own
legal name and is an authorized person, and that official may then
furnish a certified copy to the applicant.
(b) In all other circumstances, the certified copy provided to the
applicant shall be an informational certified copy and shall display
a legend that states "INFORMATIONAL, NOT A VALID DOCUMENT TO
ESTABLISH IDENTITY." The legend shall be placed on the certificate in
a manner that will not conceal information.
(c) For purposes of this section, an "authorized person" is any of
the following:
(1) The registrant or a parent or legal guardian of the
registrant.
(2) A party entitled to receive the record as a result of a court
order, or an attorney or a licensed adoption agency seeking the birth
record in order to comply with the requirements of Section 3140 or
7603 of the Family Code.
(3) A member of a law enforcement agency or a representative of
another governmental agency, as provided by law, who is conducting
official business.
(4) A child, grandparent, grandchild, sibling, spouse, or domestic
partner of the registrant.
(5) An attorney representing the registrant or the registrant's
estate, or any person or agency empowered by statute or appointed by
a court to act on behalf of the registrant or the registrant's
estate.
(6) Any agent or employee of a funeral establishment who acts
within the course and scope of his or her employment and who orders
certified copies of a death certificate on behalf of any individual
specified in paragraphs (1) to (5), inclusive, of subdivision (a) of
Section 7100.
(d) Any person who asks the agent or employee of a funeral
establishment to request a death certificate on his or her behalf
warrants the truthfulness of his or her relationship to the decedent,
and is personally liable for all damages occasioned by, or resulting
from, a breach of that warranty.
(e) Notwithstanding any other provision of law:
(1) Any member of a law enforcement agency or a representative of
a state or local government agency, as provided by law, who orders a
copy of a record to which subdivision (a) applies in conducting
official business may not be required to provide the notarized
statement required by subdivision (a).
(2) An agent or employee of a funeral establishment who acts
within the course and scope of his or her employment and who orders
death certificates on behalf of individuals specified in paragraphs
(1) to (5), inclusive, of subdivision (a) of Section 7100 shall not
be required to provide the notarized statement required by
subdivision (a).
(f) Informational certified copies of birth and death certificates
issued pursuant to subdivision (b) shall only be printed from the
single statewide database prepared by the State Registrar and shall
be electronically redacted to remove any signatures for purposes of
compliance with this section. Local registrars and county recorders
shall not issue informational certified copies of birth and death
certificates from any source other than the statewide database
prepared by the State Registrar. This subdivision shall become
operative on July 1, 2007, but only after the statewide database
becomes operational and the full calendar year of the birth and death
indices and images is entered into the statewide database and is
available for the respective year of the birth or death certificate
for which an informational copy is requested. The State Registrar
shall provide written notification to local registrars and county
recorders as soon as a year becomes available for issuance from the
statewide database.
SEC. 32. Section 103526.5 of the Health and Safety Code is amended
to read:
103526.5. (a) Each certified copy of a birth or death record
issued pursuant to Section 103525 shall include the date issued, the
name of the issuing officer, the signature of the issuing officer,
whether that is the State Registrar, local registrar, county
recorder, or county clerk, or an authorized facsimile thereof, and
the seal of the issuing office.
(b) (1) All certified copies of birth and death records issued
pursuant to Section 103525 shall be printed on chemically sensitized
security paper that measures 81/2 by 11 inches and that has the
following features:
(A) Intaglio print.
(B) Latent image.
(C) Fluorescent, consecutive numbering with matching barcode.
(D) Microprint line.
(E) Prismatic printing.
(F) Watermark.
(G) Void pantograph.
(H) Fluorescent security threads.
(I) Fluorescent fibers.
(J) Any other security features deemed necessary by the State
Registrar.
(2) In addition to the security features required by paragraph
(1), commencing January 1, 2009, the security paper used for
informational certified copies of birth and death records pursuant to
subdivision (b) of Section 103526 shall also contain a statement in
perforated type that states "INFORMATIONAL, NOT A VALID DOCUMENT TO
ESTABLISH IDENTITY."
(c) The State Registrar, local registrars, county recorders, and
county clerks shall take precautions to ensure that uniform and
consistent standards are used statewide to safeguard the security
paper described in subdivision (b), including, but not limited to,
the following measures:
(1) Security paper shall be maintained under secure conditions so
as not to be accessible to the public.
(2) A log shall be kept of all visitors allowed in the area where
security paper is stored.
(3) All spoilage shall be accounted for and subsequently destroyed
by shredding on the premises.
SEC. 33. Section 107080 of the Health and Safety Code is amended
to read:
107080. (a) The application fee for any certificate or permit
issued pursuant to the Radiologic Technology Act (Section 27) shall
be established by the department in an amount as it deems reasonably
necessary to carry out the purpose of that act.
(b) The fee for any examination conducted pursuant to the
Radiologic Technology Act (Section 27) after failure of that
examination within the previous 12 months shall be fixed by the
department in an amount it deems reasonably necessary to carry out
that act.
(c) The annual renewal fee for each certificate or permit shall be
fixed by the department in an amount it deems reasonably necessary
to carry out the Radiologic Technology Act (Section 27).
(d) The penalty fee for renewal of any certificate or permit if
application is made after its date of expiration shall be five
dollars ($5) and shall be in addition to the fee for renewal
prescribed by subdivision (c).
(e) The fee for a duplicate certificate or permit shall be one
dollar ($1).
(f) No fee shall be required for a certificate or permit or a
renewal thereof except as prescribed in the Radiologic Technology Act
(Section 27).
SEC. 34. Section 111615 of the Health and Safety Code is amended
to read:
111615. No person shall manufacture any drug or device in this
state unless he or she has a valid license from the department. The
license is valid for two calendar years from the date of issue,
unless it is revoked. The license is not transferable.
The department may require any manufacturer, wholesaler, or
importer of any prescription ophthalmic device in this state to
obtain a license.
SEC. 35. Section 111625 of the Health and Safety Code is amended
to read:
111625. A license application shall be completed biennially and
accompanied by an application fee as prescribed in Section 111630.
This fee is not refundable if the license is refused.
SEC. 36. Section 115065 of the Health and Safety Code is amended
to read:
115065. (a) Notwithstanding Section 6103 of the Government Code,
the department shall provide by regulation a schedule of the fees
that shall be paid by the following persons:
(1) Persons possessing radioactive materials under licenses issued
by the department or under other state or federal licenses for the
use of these radioactive materials, when these persons use these
radioactive materials in the state in accordance with the regulations
adopted pursuant to subdivision (d) of Section 115060.
(2) Persons generally licensed for the use of devices and
equipment utilizing radioactive materials that are designed and
manufactured for the purpose of detecting, measuring, gauging, or
controlling thickness, density, level, interface location, radiation,
leakage, or qualitative or quantitative chemical composition, or for
producing light or an ionized atmosphere, if the devices are
manufactured pursuant to a specific license authorizing distribution
to general licensees.
(b) The revenues derived from the fees shall be used, together
with other funds made available therefor, for the purpose of the
issuance of licenses or the inspection and regulation of the
licensees.
(c) The department may adopt emergency regulations pursuant to
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code to establish and adjust fees for
radioactive materials licenses in an amount to produce estimated
revenues equal to at least 95 percent of the department's costs in
carrying out these licensing requirements, if the new fees were to
remain in effect throughout the fiscal year for which the fee is
established or adjusted.
(d) A local agency participating in a negotiated agreement
pursuant to Section 114990 shall be fully reimbursed for direct and
indirect costs based upon activities governed by Section 115070. With
respect to these agreements, any salaries, benefits, and other
indirect costs shall not exceed comparable costs of the department.
(e) The fees for licenses for radioactive materials and of devices
and equipment utilizing those materials shall be adjusted annually
pursuant to Section 100425.
(f) The department shall establish fees for followup inspections
related to the failure to correct violations of this chapter or
regulations adopted pursuant to this chapter. The fees established by
the department may be charged for each inspection visit.
SEC. 37. Section 115080 of the Health and Safety Code is amended
to read:
115080. (a) Notwithstanding Section 6103 of the Government Code,
the department shall provide by regulation a ranking of priority for
inspection, as determined by the degree of potentially damaging
exposure of persons by ionizing radiation and the requirements of
Section 115085, and a schedule of fees, based upon that
priority ranking, that shall be paid by
persons possessing sources of ionizing radiation that are subject to
registration in accordance with subdivisions (b) and (e) of Section
115060, and regulations adopted pursuant thereto. The revenues
derived from the fees shall be used, together with other funds made
available therefor, for the purpose of carrying out any inspections
of the sources of ionizing radiation required by this chapter or
regulations adopted pursuant thereto. The fees shall, together with
any other funds made available to the department, be sufficient to
cover the costs of administering this chapter, and shall be set in
amounts intended to cover the costs of administering this chapter for
each priority source of ionizing radiation. Revenues generated by
the fees shall not offset any general funds appropriated for the
support of the radiologic programs authorized pursuant to this
chapter, and the Radiologic Technology Act (Section 27), and Chapter
7.6 (commencing with Section 114960). Persons who pay fees shall not
be required to pay, directly or indirectly, for the share of the
costs of administering this chapter of those persons for whom fees
are waived. The department shall take into consideration any contract
payment from the Health Care Financing Administration for
performance of inspections for Medicare certification and shall
reduce this fee accordingly.
(b) A local agency participating in a negotiated agreement
pursuant to Section 114990 shall be fully reimbursed for direct and
indirect costs based upon activities governed by Section 115085. With
respect to these agreements, any salaries, benefits, and other
indirect costs shall not exceed comparable costs of the department.
Any changes in the frequency of inspections or the level of
reimbursement to local agencies made by this section or Section
115085 during the 1985-86 Regular Session shall not affect ongoing
contracts.
(c) The fees paid by persons possessing sources of ionizing
radiation shall be adjusted annually pursuant to Section 100425.
(d) The department shall establish two different registration fees
for mammography equipment pursuant to this section based upon
whether the equipment is accredited by an independent accrediting
agency recognized under the federal Mammography Quality Standards Act
(42 U.S.C. Sec. 263b).
(e) The department shall establish fees for followup inspections
related to the failure to correct violations of this chapter or
regulations adopted pursuant to this chapter. The fees established by
the department may be charged for each inspection visit.
SEC. 38. Section 117971 is added to the Health and Safety Code, to
read:
117971. In addition to the fees collected pursuant to Section
117995, the department, in the implementation of this part, shall
recover its actual costs for services related to large quantity
medical waste generator followup inspections and enforcement
activities necessary to ensure compliance with this part. In no event
shall the department charge more than the actual costs incurred by
the department.
SEC. 39. Section 117995 of the Health and Safety Code is amended
to read:
117995. The registration and annual permit fee for large quantity
generators shall be set in following amounts:
(a) (1) A general acute care hospital, as defined in subdivision
(a) of Section 1250, that has one or more beds, but not more than 99
beds, shall pay six hundred dollars ($600), a facility with 100 or
more beds, but not more than 199 beds, shall pay eight hundred sixty
dollars ($860), a facility with 200 or more beds, but not more than
250 beds shall pay one thousand one hundred dollars ($1,100), and a
facility with 251 or more beds shall pay one thousand four hundred
dollars ($1,400).
(2) In addition to the fees specified in paragraph (1), a general
acute care hospital which is providing onsite treatment of medical
waste shall pay an annual medical waste treatment facility inspection
and permit fee of three hundred dollars ($300), if the facility has
one or more beds but not more than 99 beds, five hundred dollars
($500), if the facility has 100 or more beds but not more than 250
beds, and one thousand dollars ($1,000), if the facility has 251 or
more beds.
(b) A specialty clinic, providing surgical, dialysis, or
rehabilitation services, as defined in subdivision (b) of Section
1204, shall pay three hundred fifty dollars ($350).
(c) A skilled nursing facility, as defined in subdivision (c) of
Section 1250, that has one or more beds, but not more than 99 beds
shall pay two hundred seventy-five dollars ($275), a facility with
100 or more beds, but not more than 199 beds shall pay three hundred
fifty dollars ($350), and a facility with 200 or more beds shall pay
four hundred dollars ($400).
(d) An acute psychiatric hospital, as defined in subdivision (b)
of Section 1250, shall pay two hundred dollars ($200).
(e) An intermediate care facility, as defined in subdivision (d)
of Section 1250, shall pay three hundred dollars ($300).
(f) A primary care clinic, as defined in Section 1200.1, shall pay
three hundred fifty dollars ($350).
(g) A licensed clinical laboratory, as defined in paragraph (3) of
subdivision (a) of Section 1206 of the Business and Professions
Code, shall pay two hundred dollars ($200).
(h) A health care service plan facility, as defined in subdivision
(f) of Section 1345, shall pay three hundred fifty dollars ($350).
(i) A veterinary clinic or veterinary hospital shall pay two
hundred dollars ($200).
(j) A large quantity generator medical office shall pay two
hundred dollars ($200).
(k) In addition to the fees specified in subdivisions (b) to (j),
inclusive, a large quantity generator of medical waste which is
providing onsite treatment of medical waste shall pay an annual
medical waste treatment facility inspection and permit fee of three
hundred dollars ($300).
(l) The department may collect annual fees and issue permits on a
biennial basis.
SEC. 40. Section 118210 of the Health and Safety Code is amended
to read:
118210. (a) The department shall charge an annual permit fee for
an offsite medical waste treatment facility equal to either one
hundred twenty-seven ten thousandths of a cent ($0.0127) for each
pound of medical waste treated or twelve thousand dollars ($12,000),
whichever is greater. The department may collect annual fees and
issue permits on a biennial basis.
(b) The department shall charge an initial application fee for
each type of treatment technology at an offsite medical waste
treatment facility equal to one hundred dollars ($100) for each hour
the department spends processing the application, but not more than
fifty thousand dollars ($50,000), or as provided in the regulations
adopted by the department.
SEC. 41. Section 124977 of the Health and Safety Code is amended
to read:
124977. (a) It is the intent of the Legislature that, unless
otherwise specified, the program carried out pursuant to this chapter
be fully supported from fees collected for services provided by the
program.
(b) (1) The department shall charge a fee to all payers for any
tests or activities performed pursuant to this chapter. The amount of
the fee shall be established by regulation and periodically adjusted
by the director in order to meet the costs of this chapter.
Notwithstanding any other provision of law, any fees charged for
prenatal screening and followup services provided to persons enrolled
in the Medi-Cal program, health care service plan enrollees, or
persons covered by health insurance policies, shall be paid in full
directly to the Genetic Disease Testing Fund, subject to all terms
and conditions of each enrollee's or insured's health care service
plan or insurance coverage, whichever is applicable, including, but
not limited to, copayments and deductibles applicable to these
services, and only if these copayments, deductibles, or limitations
are disclosed to the subscriber or enrollee pursuant to the
disclosure provisions of Section 1363.
(2) The department shall expeditiously undertake all steps
necessary to implement the fee collection process, including
personnel, contracts, and data processing, so as to initiate the fee
collection process at the earliest opportunity.
(3) The director shall convene, in the most cost-efficient manner
and using existing resources, a working group comprised of health
insurance, health care service plan, hospital, consumer, and
department representatives to evaluate newborn and prenatal screening
fee billing procedures, and recommend to the department ways to
improve these procedures in order to improve efficiencies and enhance
revenue collections for the department and hospitals. In performing
its duties, the working group may consider models in other states.
The working group shall make its recommendations by March 1, 2005.
(4) Effective for services provided on and after July 1, 2002, the
department shall charge a fee to the hospital of birth, or, for
births not occurring in a hospital, to families of the newborn, for
newborn screening and followup services. The hospital of birth and
families of newborns born outside the hospital shall make payment in
full to the Genetic Disease Testing Fund. The department shall not
charge or bill Medi-Cal beneficiaries for services provided under
this chapter.
(c) (1) The Legislature finds that timely implementation of
changes in genetic screening programs and continuous maintenance of
quality statewide services requires expeditious regulatory and
administrative procedures to obtain the most cost-effective
electronic data processing, hardware, software services, testing
equipment, and testing and followup services.
(2) The expenditure of funds from the Genetic Disease Testing Fund
for these purposes shall not be subject to Section 12102 of, and
Chapter 2 (commencing with Section 10290) of Part 2 of Division 2 of,
the Public Contract Code, or to Division 25.2 (commencing with
Section 38070). The department shall provide the Department of
Finance with documentation that equipment and services have been
obtained at the lowest cost consistent with technical requirements
for a comprehensive high-quality program.
(3) The expenditure of funds from the Genetic Disease Testing Fund
for implementation of the Tandem Mass Spectrometry screening for
fatty acid oxidation, amino acid, and organic acid disorders, and
screening for congenital adrenal hyperplasia may be implemented
through the amendment of the Genetic Disease Branch Screening
Information System contracts and shall not be subject to Chapter 3
(commencing with Section 12100) of Part 2 of Division 2 of the Public
Contract Code, Article 4 (commencing with Section 19130) of Chapter
5 of Part 2 of Division 5 of Title 2 of the Government Code, and any
policies, procedures, regulations or manuals authorized by those
laws.
(4) The expenditure of funds from the Genetic Disease Testing Fund
for the expansion of the Genetic Disease Branch Screening
Information System to include cystic fibrosis and biotinidase may be
implemented through the amendment of the Genetic Disease Branch
Screening Information System contracts, and shall not be subject to
Chapter 2 (commencing with Section 10290) or Chapter 3 (commencing
with Section 12100) of Part 2 of Division 2 of the Public Contract
Code, Article 4 (commencing with Section 19130) of Chapter 5 of Part
2 of Division 5 of Title 2 of the Government Code, or Sections 4800
to 5180, inclusive, of the State Administrative Manual as they relate
to approval of information technology projects or approval of
increases in the duration or costs of information technology
projects. This paragraph shall apply to the design, development, and
implementation of the expansion, and to the maintenance and operation
of the Genetic Disease Branch Screening Information System,
including change requests, once the expansion is implemented.
(d) (1) The department may adopt emergency regulations to
implement and make specific this chapter in accordance with Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code. For the purposes of the Administrative
Procedure Act, the adoption of regulations shall be deemed an
emergency and necessary for the immediate preservation of the public
peace, health and safety, or general welfare. Notwithstanding Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code, these emergency regulations shall not be
subject to the review and approval of the Office of Administrative
Law. Notwithstanding Section 11346.1 and Section 11349.6 of the
Government Code, the department shall submit these regulations
directly to the Secretary of State for filing. The regulations shall
become effective immediately upon filing by the Secretary of State.
Regulations shall be subject to public hearing within 120 days of
filing with the Secretary of State and shall comply with Sections
11346.8 and 11346.9 of the Government Code or shall be repealed.
(2) The Office of Administrative Law shall provide for the
printing and publication of these regulations in the California Code
of Regulations. Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code, the
regulations adopted pursuant to this chapter shall not be repealed
by the Office of Administrative Law and shall remain in effect until
revised or repealed by the department.
(3) The Legislature finds and declares that the health and safety
of California newborns is in part dependent on an effective and
adequately staffed genetic disease program, the cost of which shall
be supported by the fees generated by the program.
SEC. 42. Section 12693.70 of the Insurance Code is amended to
read:
12693.70. To be eligible to participate in the program, an
applicant shall meet all of the following requirements:
(a) Be an applicant applying on behalf of an eligible child, which
means a child who is all of the following:
(1) Less than 19 years of age. An application may be made on
behalf of a child not yet born up to three months prior to the
expected date of delivery. Coverage shall begin as soon as
administratively feasible, as determined by the board, after the
board receives notification of the birth. However, no child less than
12 months of age shall be eligible for coverage until 90 days after
the enactment of the Budget Act of 1999.
(2) Not eligible for no-cost full-scope Medi-Cal or Medicare
coverage at the time of application.
(3) In compliance with Sections 12693.71 and 12693.72.
(4) A child who meets citizenship and immigration status
requirements that are applicable to persons participating in the
program established by Title XXI of the Social Security Act, except
as specified in Section 12693.76.
(5) A resident of the State of California pursuant to Section 244
of the Government Code; or, if not a resident pursuant to Section 244
of the Government Code, is physically present in California and
entered the state with a job commitment or to seek employment,
whether or not employed at the time of application to or after
acceptance in, the program.
(6) (A) In either of the following:
(i) In a family with an annual or monthly household income equal
to or less than 200 percent of the federal poverty level.
(ii) When implemented by the board, subject to subdivision (b) of
Section 12693.765 and pursuant to this section, a child under the age
of two years who was delivered by a mother enrolled in the Access
for Infants and Mothers Program as described in Part 6.3 (commencing
with Section 12695). Commencing July 1, 2007, eligibility under this
subparagraph shall not include infants during any time they are
enrolled in employer-sponsored health insurance or are subject to an
exclusion pursuant to Section 12693.71 or 12693.72, or are enrolled
in the full-scope of benefits under the Medi-Cal program at no share
of cost. For purposes of this clause, any infant born to a woman
whose enrollment in the Access for Infants and Mothers Program begins
after June 30, 2004, shall be automatically enrolled in the Healthy
Families Program, except during any time on or after July 1, 2007,
that the infant is enrolled in employer-sponsored health insurance or
is subject to an exclusion pursuant to Section 12693.71 or 12693.72,
or is enrolled in the full-scope of benefits under the Medi-Cal
program at no share of cost. Except as otherwise specified in this
section, this enrollment shall cover the first 12 months of the
infant's life. At the end of the 12 months, as a condition of
continued eligibility, the applicant shall provide income
information. The infant shall be disenrolled if the gross annual
household income exceeds the income eligibility standard that was in
effect in the Access for Infants and Mothers Program at the time the
infant's mother became eligible, or following the two-month period
established in Section 12693.981 if the infant is eligible for
Medi-Cal with no share of cost. At the end of the second year,
infants shall again be screened for program eligibility pursuant to
this section, with income eligibility evaluated pursuant to clause
(i), subparagraphs (B) and (C), and paragraph (2) of subdivision (a).
(B) All income over 200 percent of the federal poverty level but
less than or equal to 250 percent of the federal poverty level shall
be disregarded in calculating annual or monthly household income.
(C) In a family with an annual or monthly household income greater
than 250 percent of the federal poverty level, any income deduction
that is applicable to a child under Medi-Cal shall be applied in
determining the annual or monthly household income. If the income
deductions reduce the annual or monthly household income to 250
percent or less of the federal poverty level, subparagraph (B) shall
be applied.
(b) The applicant shall agree to remain in the program for six
months, unless other coverage is obtained and proof of the coverage
is provided to the program.
(c) An applicant shall enroll all of the applicant's eligible
children in the program.
(d) In filing documentation to meet program eligibility
requirements, if the applicant's income documentation cannot be
provided, as defined in regulations promulgated by the board, the
applicant's signed statement as to the value or amount of income
shall be deemed to constitute verification.
(e) An applicant shall pay in full any family contributions owed
in arrears for any health, dental, or vision coverage provided by the
program within the prior 12 months.
SEC. 43. Section 12695.03 is added to the Insurance Code, to read:
12695.03. "AIM-linked infant" means any infant born to a woman
whose enrollment in the Access for Infants and Mothers Program begins
after June 30, 2004.
SEC. 44. Section 12696.05 of the Insurance Code is amended to
read:
12696.05. The board may do all of the following:
(a) Determine eligibility criteria for the program. These criteria
shall include the requirements set forth in Section 12698.
(b) Determine the eligibility of applicants.
(c) Determine when subscribers are covered and the extent and
scope of coverage.
(d) Determine subscriber contribution amounts schedules.
(1) Subscriber contribution amounts for care provided to the
subscriber shall be indexed to the federal poverty level and shall
not exceed 2 percent of a subscriber's annual gross family income.
(2) In addition to any other subscriber contribution specified in
this subdivision, for subscribers enrolled on or after July 1, 2007,
the board may also assess an additional subscriber contribution to
cover the AIM-linked infant enrolled in the Healthy Families Program
pursuant to clause (ii) of subparagraph (A) of paragraph (6) of
subdivision (a) of Section 12693.70 for two months, using all
applicable discounts pursuant to Section 12693.43.
(3) The board shall determine the manner in which the subscriber
contributions are to be applied, including the order in which they
are applied.
(e) Provide coverage through participating health plans or through
coordination with other state programs, and contract for the
processing of applications and the enrollment of subscribers. Any
contract entered into pursuant to this part shall be exempt from any
provision of law relating to competitive bidding, and shall be exempt
from the review or approval of any division of the Department of
General Services. The board shall not be required to specify the
amounts encumbered for each contract, but may allocate funds to each
contract based on projected and actual subscriber enrollments in a
total amount not to exceed the amount appropriated for the program.
(f) Authorize expenditures from the fund to pay program expenses
which exceed subscriber contributions, and to administer the program
as necessary.
(g) Develop a promotional component of the program to make
Californians aware of the program and the opportunity that it
presents.
(h) Issue rules and regulations as necessary to administer the
program. All rules and regulations issued pursuant to this
subdivision that manage program integrity, revise the benefit
package, or reduce the eligibility criteria below 300 percent of the
federal poverty level may be adopted as emergency regulations in
accordance with the Administrative Procedure Act (Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code). The adoption of these regulations shall be
deemed an emergency and necessary for the immediate preservation of
the public peace, health, and safety, or general welfare. The
regulations shall become effective immediately upon filing with the
Secretary of State.
(i) Exercise all powers reasonably necessary to carry out the
powers and responsibilities expressly granted or imposed by this
part.
SEC. 45. Section 12699 of the Insurance Code is amended to read:
12699. (a) The Perinatal Insurance Fund is hereby created in the
State Treasury.
(b) Amounts deposited in the fund shall only be used for the
purposes specified by this chapter.
(c) Notwithstanding Section 13340 of the Government Code, the fund
is hereby continuously appropriated, without regard to fiscal years,
to the board, for the purposes specified in this part.
(d) The board shall determine the portion of the subscriber
contribution that shall be transferred from the Perinatal Insurance
Fund to the Healthy Families Fund for the payment of the Healthy
Families Program premium for the AIM-linked infant pursuant to
paragraph (2) of subdivision (d) of Section 12696.05.
SEC. 46. Section 830.3 of the Penal Code is amended to read:
830.3. The following persons are peace officers whose authority
extends to any place in the state for the purpose of performing their
primary duty or when making an arrest pursuant to Section 836 of the
Penal Code as to any public offense with respect to which there is
immediate danger to person or property, or of the escape of the
perpetrator of that offense, or pursuant to Section 8597 or 8598 of
the Government Code. These peace officers may carry firearms only if
authorized and under those terms and conditions as specified by their
employing agencies:
(a) Persons employed by the Division of Investigation of the
Department of Consumer Affairs and investigators of the Medical Board
of California and the Board of Dental Examiners, who are designated
by the Director of Consumer Affairs, provided that the primary duty
of these peace officers shall be the enforcement of the law as that
duty is set forth in Section 160 of the Business and Professions
Code.
(b) Voluntary fire wardens designated by the Director of Forestry
and Fire Protection pursuant to Section 4156 of the Public Resources
Code, provided that the primary duty of these peace officers shall be
the enforcement of the law as that duty is set forth in Section 4156
of that code.
(c) Employees of the Department of Motor Vehicles designated in
Section 1655 of the Vehicle Code, provided that the primary duty of
these peace officers shall be the enforcement of the law as that duty
is set forth in Section 1655 of that code.
(d) Investigators of the California Horse Racing Board designated
by the board, provided that the primary duty of these peace officers
shall be the enforcement of Chapter 4 (commencing with Section 19400)
of Division 8 of the Business and Professions Code and Chapter 10
(commencing with Section 330) of Title 9 of Part 1 of this code.
(e) The State Fire Marshal and assistant or deputy state fire
marshals appointed pursuant to Section 13103 of the Health and Safety
Code, provided that the primary duty of these peace officers shall
be the enforcement of the law as that duty is set forth in Section
13104 of that code.
(f) Inspectors of the food and drug section designated by the
chief pursuant to subdivision (a) of Section 106500 of the Health and
Safety Code, provided that the primary duty of these peace officers
shall be the enforcement of the law as that duty is set forth in
Section 106500 of that code.
(g) All investigators of the Division of Labor Standards
Enforcement designated by the Labor Commissioner, provided that the
primary duty of these peace officers shall be the enforcement of the
law as prescribed in Section 95 of the Labor Code.
(h) All investigators of the State Departments of Health Services,
Social Services, Mental Health, and Alcohol and Drug Programs, the
Department of Toxic Substances Control, the Office of Statewide
Health Planning and Development, and the Public Employees' Retirement
System, provided that the primary duty of these peace officers shall
be the enforcement of the law relating to the duties of his or her
department or office. Notwithstanding any other provision of law,
investigators of the Public Employees' Retirement System shall not
carry firearms.
(i) The Chief of the Bureau of Fraudulent Claims of the Department
of Insurance and those investigators designated by the chief,
provided that the primary duty of those investigators shall be the
enforcement of Section 550.
(j) Employees of the Department of Housing and Community
Development designated under Section 18023 of the Health and Safety
Code, provided that the primary duty of these peace officers shall be
the enforcement of the law as that duty is set forth in Section
18023 of that code.
(k) Investigators of the office of the Controller, provided that
the primary duty of these investigators shall be the enforcement of
the law relating to the
duties of that office. Notwithstanding any other law, except as
authorized by the Controller, the peace officers designated pursuant
to this subdivision shall not carry firearms.
(l) Investigators of the Department of Corporations designated by
the Commissioner of Corporations, provided that the primary duty of
these investigators shall be the enforcement of the provisions of law
administered by the Department of Corporations. Notwithstanding any
other provision of law, the peace officers designated pursuant to
this subdivision shall not carry firearms.
(m) Persons employed by the Contractors' State License Board
designated by the Director of Consumer Affairs pursuant to Section
7011.5 of the Business and Professions Code, provided that the
primary duty of these persons shall be the enforcement of the law as
that duty is set forth in Section 7011.5, and in Chapter 9
(commencing with Section 7000) of Division 3, of that code. The
Director of Consumer Affairs may designate as peace officers not more
than three persons who shall at the time of their designation be
assigned to the special investigations unit of the board.
Notwithstanding any other provision of law, the persons designated
pursuant to this subdivision shall not carry firearms.
(n) The Chief and coordinators of the Law Enforcement Division of
the Office of Emergency Services.
(o) Investigators of the office of the Secretary of State
designated by the Secretary of State, provided that the primary duty
of these peace officers shall be the enforcement of the law as
prescribed in Chapter 3 (commencing with Section 8200) of Division 1
of Title 2 of, and Section 12172.5 of, the Government Code.
Notwithstanding any other provision of law, the peace officers
designated pursuant to this subdivision shall not carry firearms.
(p) The Deputy Director for Security designated by Section 8880.38
of the Government Code, and all lottery security personnel assigned
to the California State Lottery and designated by the director,
provided that the primary duty of any of those peace officers shall
be the enforcement of the laws related to assuring the integrity,
honesty, and fairness of the operation and administration of the
California State Lottery.
(q) Investigators employed by the Investigation Division of the
Employment Development Department designated by the director of the
department, provided that the primary duty of those peace officers
shall be the enforcement of the law as that duty is set forth in
Section 317 of the Unemployment Insurance Code.
Notwithstanding any other provision of law, the peace officers
designated pursuant to this subdivision shall not carry firearms.
(r) The chief and assistant chief of museum security and safety of
the California Science Center, as designated by the executive
director pursuant to Section 4108 of the Food and Agricultural Code,
provided that the primary duty of those peace officers shall be the
enforcement of the law as that duty is set forth in Section 4108 of
the Food and Agricultural Code.
(s) Employees of the Franchise Tax Board designated by the board,
provided that the primary duty of these peace officers shall be the
enforcement of the law as set forth in Chapter 9 (commencing with
Section 19701) of Part 10.2 of Division 2 of the Revenue and Taxation
Code.
(t) Notwithstanding any other provision of this section, a peace
officer authorized by this section shall not be authorized to carry
firearms by his or her employing agency until that agency has adopted
a policy on the use of deadly force by those peace officers, and
until those peace officers have been instructed in the employing
agency's policy on the use of deadly force.
Every peace officer authorized pursuant to this section to carry
firearms by his or her employing agency shall qualify in the use of
the firearms at least every six months.
(u) Investigators of the Department of Managed Health Care
designated by the Director of the Department of Managed Health Care,
provided that the primary duty of these investigators shall be the
enforcement of the provisions of laws administered by the Director of
the Department of Managed Health Care. Notwithstanding any other
provision of law, the peace officers designated pursuant to this
subdivision shall not carry firearms.
(v) The Chief, Deputy Chief, supervising investigators, and
investigators of the Office of Protective Services of the State
Department of Developmental Services, provided that the primary duty
of each of those persons shall be the enforcement of the law relating
to the duties of his or her department or office.
SEC. 47. Section 4107 of the Welfare and Institutions Code is
amended to read:
4107. (a) The security of patients committed pursuant to Section
1026 of, and Chapter 6 (commencing with Section 1367) of Title 10 of
Part 2 of, the Penal Code, and former Sections 6316 and 6321 of the
Welfare and Institutions Code, at Patton State Hospital shall be the
responsibility of the Director of the Department of Corrections.
(b) The Department of Corrections and the State Department of
Mental Health shall jointly develop a plan to transfer all patients
committed to Patton State Hospital pursuant to the provisions in
subdivision (a) from Patton State Hospital no later than January 1,
1986, and shall transmit this plan to the Senate Committee on
Judiciary and to the Assembly Committee on Criminal Justice, and to
the Senate Health and Welfare Committee and Assembly Health Committee
by June 30, 1983. The plan shall address whether the transferred
patients shall be moved to other state hospitals or to correctional
facilities, or both, for commitment and treatment.
(c) Notwithstanding any other provision of law, the State
Department of Mental Health shall house no more than 1,336 patients
at Patton State Hospital. However, until September 2009, up to 1,530
patients may be housed at the hospital.
(d) The Department of Corrections and the State Department of
Mental Health shall jointly develop a plan for ensuring the external
and internal security of the hospital during the construction of
additional beds at Patton State Hospital and the establishment of
related modular program space for which funding is provided in the
Budget Act of 2001. No funds shall be expended for the expansion
project until 30 days after the date upon which the plan is submitted
to the fiscal committees of the Legislature and the Chair of the
Joint Legislative Budget Committee.
(e) The Department of Corrections and the State Department of
Mental Health shall also jointly develop a plan for ensuring the
external and internal security of the hospital upon the occupation of
the additional beds at Patton State Hospital. These beds shall not
be occupied by patients until the later of the date that is 30 days
after the date upon which the plan is submitted to the Chair of the
Joint Legislative Budget Committee or the date upon which it is
implemented by the departments.
(f) This section shall remain in effect only until all patients
committed, pursuant to the provisions enumerated in subdivision (a),
have been removed from Patton State Hospital and shall have no force
or effect on or after that date.
SEC. 48. Section 4640.6 of the Welfare and Institutions Code is
amended to read:
4640.6. (a) In approving regional center contracts, the
department shall ensure that regional center staffing patterns
demonstrate that direct service coordination are the highest
priority.
(b) Contracts between the department and regional centers shall
require that regional centers implement an emergency response system
that ensures that a regional center staff person will respond to a
consumer, or individual acting on behalf of a consumer, within two
hours of the time an emergency call is placed. This emergency
response system shall be operational 24 hours per day, 365 days per
year.
(c) Contracts between the department and regional centers shall
require regional centers to have service coordinator-to-consumer
ratios, as follows:
(1) An average service coordinator-to-consumer ratio of 1 to 62
for all consumers who have not moved from the developmental centers
to the community since April 14, 1993. In no case shall a service
coordinator for these consumers have an assigned caseload in excess
of 79 consumers for more than 60 days.
(2) An average service coordinator-to-consumer ratio of 1 to 45
for all consumers who have moved from a developmental center to the
community since April 14, 1993. In no case shall a service
coordinator for these consumers have an assigned caseload in excess
of 59 consumers for more than 60 days.
(3) Commencing January 1, 2004, to June 30, 2007, inclusive, the
following coordinator-to-consumer ratios shall apply:
(A) All consumers three years of age and younger and for consumers
enrolled on the Home and Community-based Services Waiver for persons
with developmental disabilities, an average service
coordinator-to-consumer ratio of 1 to 62.
(B) All consumers who have moved from a developmental center to
the community since April 14, 1993, and have lived continuously in
the community for at least 12 months, an average service
coordinator-to-consumer ratio of 1 to 62.
(C) All consumers who have not moved from the developmental
centers to the community since April 14, 1993, and who are not
described in subparagraph (A), an average service
coordinator-to-consumer ratio of 1 to 66.
(4) For purposes of paragraph (3), service coordinators may have a
mixed caseload of consumers three years of age and younger,
consumers enrolled on the Home and Community-based Services Waiver
program for persons with developmental disabilities, and other
consumers if the overall average caseload is weighted proportionately
to ensure that overall regional center average service
coordinator-to-consumer ratios as specified in paragraph (3) are met.
For purposes of paragraph (3), in no case shall a service
coordinator have an assigned caseload in excess of 84 for more than
60 days.
(d) For purposes of this section, "service coordinator" means a
regional center employee whose primary responsibility includes
preparing, implementing, and monitoring consumers' individual program
plans, securing and coordinating consumer services and supports, and
providing placement and monitoring activities.
(e) In order to ensure that caseload ratios are maintained
pursuant to this section, each regional center shall provide service
coordinator caseload data to the department, annually for each fiscal
year. The data shall be submitted in the format, including the
content, prescribed by the department. Within 30 days of receipt of
data submitted pursuant to this subdivision, the department shall
make a summary of the data available to the public upon request. The
department shall verify the accuracy of the data when conducting
regional center fiscal audits. Data submitted by regional centers
pursuant to this subdivision shall:
(1) Only include data on service coordinator positions as defined
in subdivision (d). Regional centers shall identify the number of
positions that perform service coordinator duties on less than a
full-time basis. Staffing ratios reported pursuant to this
subdivision shall reflect the appropriate proportionality of these
staff to consumers served.
(2) Be reported separately for service coordinators whose caseload
includes any of the following:
(A) Consumers who are three years of age and older and who have
not moved from the developmental center to the community since April
14, 1993.
(B) Consumers who have moved from a developmental center to the
community since April 14, 1993.
(C) Consumers who are younger than three years of age.
(D) Consumers enrolled in the Home and Community-based Services
Waiver program.
(3) Not include positions that are vacant for more than 60 days or
new positions established within 60 days of the reporting month that
are still vacant.
(4) For purposes of calculating caseload ratios for consumers
enrolled in the Home- and Community-based Services Waiver program,
vacancies shall not be included in the calculations.
(f) The department shall provide technical assistance and require
a plan of correction for any regional center that, for two
consecutive reporting periods, fails to maintain service coordinator
caseload ratios required by this section or otherwise demonstrates an
inability to maintain appropriate staffing patterns pursuant to this
section. Plans of correction shall be developed following input
from the local area board, local organizations representing
consumers, family members, regional center employees, including
recognized labor organizations, and service providers, and other
interested parties.
(g) Contracts between the department and regional center shall
require the regional center to have, or contract for, all of the
following areas:
(1) Criminal justice expertise to assist the regional center in
providing services and support to consumers involved in the criminal
justice system as a victim, defendant, inmate, or parolee.
(2) Special education expertise to assist the regional center in
providing advocacy and support to families seeking appropriate
educational services from a school district.
(3) Family support expertise to assist the regional center in
maximizing the effectiveness of support and services provided to
families.
(4) Housing expertise to assist the regional center in accessing
affordable housing for consumers in independent or supportive living
arrangements.
(5) Community integration expertise to assist consumers and
families in accessing integrated services and supports and improved
opportunities to participate in community life.
(6) Quality assurance expertise, to assist the regional center to
provide the necessary coordination and cooperation with the area
board in conducting quality-of-life assessments and coordinating the
regional center quality assurance efforts.
(7) Each regional center shall employ at least one consumer
advocate who is a person with developmental disabilities.
(8) Other staffing arrangements related to the delivery of
services that the department determines are necessary to ensure
maximum cost-effectiveness and to ensure that the service needs of
consumers and families are met.
(h) Any regional center proposing a staffing arrangement that
substantially deviates from the requirements of this section shall
request a waiver from the department. Prior to granting a waiver, the
department shall require a detailed staffing proposal, including,
but not limited to, how the proposed staffing arrangement will
benefit consumers and families served, and shall demonstrate clear
and convincing support for the proposed staffing arrangement from
constituencies served and impacted, that include, but are not limited
to, consumers, families, providers, advocates, and recognized labor
organizations. In addition, the regional center shall submit to the
department any written opposition to the proposal from organizations
or individuals, including, but not limited to, consumers, families,
providers, and advocates, including recognized labor organizations.
The department may grant waivers to regional centers that
sufficiently demonstrate that the proposed staffing arrangement is in
the best interest of consumers and families served, complies with
the requirements of this chapter, and does not violate any
contractual requirements. A waiver shall be approved by the
department for up to 12 months, at which time a regional center may
submit a new request pursuant to this subdivision.
(i) The requirements of subdivisions (c), (f), and (h) shall not
apply when a regional center is required to develop an expenditure
plan pursuant to Section 4791, and when the expenditure plan
addresses the specific impact of the budget reduction on staffing
requirements and the expenditure plan is approved by the department.
(j) (1) Any contract between the department and a regional center
entered into on and after January 1, 2003, shall require that all
employment contracts entered into with regional center staff or
contractors be available to the public for review, upon request. For
purposes of this subdivision, an employment contract or portion
thereof may not be deemed confidential nor unavailable for public
review.
(2) Notwithstanding paragraph (1), the social security number of
the contracting party may not be disclosed.
(3) The term of the employment contract between the regional
center and an employee or contractor shall not exceed the term of the
state's contract with the regional center.
SEC. 49. Section 4643 of the Welfare and Institutions Code is
amended to read:
4643. (a) If assessment is needed, prior to July 1, 2007, the
assessment shall be performed within 120 days following initial
intake. Assessment shall be performed as soon as possible and in no
event more than 60 days following initial intake where any delay
would expose the client to unnecessary risk to his or her health and
safety or to significant further delay in mental or physical
development, or the client would be at imminent risk of placement in
a more restrictive environment. Assessment may include collection and
review of available historical diagnostic data, provision or
procurement of necessary tests and evaluations, and summarization of
developmental levels and service needs and is conditional upon
receipt of the release of information specified in subdivision (b).
On and after July 1, 2007, the assessment shall be performed within
60 days following intake and if unusual circumstances prevent the
completion of assessment within 60 days following intake, this
assessment period may be extended by one 30-day period with the
advance written approval of the department.
(b) In determining if an individual meets the definition of
developmental disability contained in subdivision (a) of Section
4512, the regional center may consider evaluations and tests,
including, but not limited to, intelligence tests, adaptive
functioning tests, neurological and neuropsychological tests,
diagnostic tests performed by a physician, psychiatric tests, and
other tests or evaluations that have been performed by, and are
available from, other sources.
SEC. 50. Section 4648.4 of the Welfare and Institutions Code is
amended to read:
4648.4. (a) Notwithstanding any other provision of law or
regulation, commencing July 1, 2006, rates for services listed in
paragraphs (1), (2), with the exception of travel reimbursement, (3)
to (8), inclusive, (10), and (11) of subdivision (b), shall be
increased by 3 percent, subject to funds specifically appropriated
for this increase in the Budget Act of 2006. The increase shall be
applied as a percentage, and the percentage shall be the same for all
providers. Any subsequent change shall be governed by subdivision
(b).
(b) Notwithstanding any other provision of law or regulation,
except for subdivision (a), during the 2006-07 fiscal year, no
regional center may pay any provider of the following services or
supports a rate that is greater than the rate that is in effect on or
after July 1, 2006, unless the increase is required by a contract
between the regional center and the vendor that is in effect on June
30, 2006, or the regional center demonstrates that the approval is
necessary to protect the consumer's health or safety and the
department has granted prior written authorization:
(1) Supported living services.
(2) Transportation, including travel reimbursement.
(3) Socialization training programs.
(4) Behavior intervention training.
(5) Community integration training programs.
(6) Community activities support services.
(7) Mobile day programs.
(8) Creative art programs.
(9) Supplemental day services program supports.
(10) Adaptive skills trainers.
(11) Independent living specialists.
SEC. 51. Section 4681.3 of the Welfare and Institutions Code is
amended to read:
4681.3. (a) Notwithstanding any other provision of this article,
for the 1996-97 fiscal year, the rate schedule authorized by the
department in operation June 30, 1996, shall be increased based upon
the amount appropriated in the Budget Act of 1996 for that purpose.
The increase shall be applied as a percentage, and the percentage
shall be the same for all providers.
(b) Notwithstanding any other provision of this article, for the
1997-98 fiscal year, the rate schedule authorized by the department
in operation on June 30, 1997, shall be increased based upon the
amount appropriated in the Budget Act of 1997 for that purpose. The
increase shall be applied as a percentage, and the percentage shall
be the same for all providers.
(c) Notwithstanding any other provision of this article, for the
1998-99 fiscal year, the rate schedule authorized by the department
in operation on June 30, 1998, shall be increased commencing July 1,
1998, based upon the amount appropriated in the Budget Act of 1998
for that purpose. The increase shall be applied as a percentage, and
the percentage shall be the same for all providers.
(d) Notwithstanding any other provision of this article, for the
1998-99 fiscal year, the rate schedule authorized by the department
in operation on December 31, 1998, shall be increased January 1,
1999, based upon the cost-of-living adjustments in the Supplemental
Security Income/State Supplementary Program for the Aged, Blind, and
Disabled appropriated in the Budget Act of 1998 for that purpose. The
increase shall be applied as a percentage and the percentage shall
be the same for all providers.
(e) Notwithstanding any other provision of this article, for the
1999-2000 fiscal year, the rate schedule authorized by the department
in operation on June 30, 1999, shall be increased July 1, 1999,
based upon the amount appropriated in the Budget Act of 1999 for that
purpose. The increase shall be applied as a percentage and the
percentage shall be the same for all providers.
(f) In addition, commencing January 1, 2000, any funds available
from cost-of-living adjustments in the Supplemental Security
Income/State Supplementary Payment (SSI/SSP) for the 1999-2000 fiscal
year shall be used to further increase the community care facility
rate. The increase shall be applied as a percentage, and the
percentage shall be the same for all providers.
(g) Notwithstanding any other provision of law or regulation, for
the 2006-07 fiscal year, the rate schedule in effect on June 30,
2006, shall be increased on July 1, 2006, by 3 percent, subject to
funds specifically appropriated for this increase in the Budget Act
of 2006. The increase shall be applied as a percentage and the
percentage shall be the same for all providers. Any subsequent
increase shall be governed by Section 4681.5.
SEC. 52. Section 4681.5 of the Welfare and Institutions Code is
amended to read:
4681.5. Notwithstanding any other provision of law or regulation,
during the 2006-07 fiscal year, no regional center may approve any
service level for a residential service provider, as defined in
Section 56005 of Title 17 of the California Code of Regulations, if
the approval would result in an increase in the rate to be paid to
the provider that is greater than the rate that is in effect on July
1, 2006, unless the regional center demonstrates to the department
that the approval is necessary to protect the consumer's health or
safety and the department has granted prior written authorization.
SEC. 53. Section 4690.5 is added to the Welfare and Institutions
Code, to read:
4690.5. Notwithstanding any other provision of law or regulation,
commencing July 1, 2006, the rate for family member-provided respite
services authorized by the department and in operation June 30,
2006, shall be increased by 3 percent, subject to funds specifically
appropriated for this increase in the Budget Act of 2006. The
increase shall be applied as a percentage, and the percentage shall
be the same for all providers.
SEC. 54. Section 4691.6 of the Welfare and Institutions Code is
amended to read:
4691.6. (a) Notwithstanding any other provision of law or
regulation, commencing July 1, 2006, the community-based day program,
work activity program, and in-home respite service agency rate
schedules authorized by the department and in operation June 30,
2006, shall be increased by 3 percent, subject to funds specifically
appropriated for this increase in the Budget Act of 2006. The
increase shall be applied as a percentage, and the percentage shall
be the same for all providers. Any subsequent increase shall be
governed by subdivisions (b), (c), (d), and (e).
(b) Notwithstanding any other provision of law or regulation,
during the 2006-07 fiscal year, the department may not establish any
permanent payment rate for a community-based day program or in-home
respite service agency provider that has a temporary payment rate in
effect on July 1, 2006, if the permanent payment rate would be
greater than the temporary payment rate in effect on or after July 1,
2006, unless the regional center demonstrates to the department that
the permanent payment rate is necessary to protect the consumers'
health or safety.
(c) Notwithstanding any other provision of law or regulation,
during the 2006-07 fiscal year, neither the department nor any
regional center may approve any program design modification or
revendorization for a community-based day program or in-home respite
service agency provider that would result in an increase in the rate
to be paid to the vendor from the rate that is in effect on or after
July 1, 2006, unless the regional center demonstrates that the
program design modification or revendorization is necessary to
protect the consumers' health or safety and the department has
granted prior written authorization.
(d) Notwithstanding any other provision of law or regulation,
during the 2006-07 fiscal year, the department may not approve an
anticipated rate adjustment for a community-based day program or
in-home respite service agency provider that would result in an
increase in the rate to be paid to the vendor from the rate that is
in effect on or after July 1, 2006, unless the regional center
demonstrates that the anticipated rate adjustment is necessary to
protect the consumers' health or safety.
(e) Notwithstanding any other provision of law or regulation,
during the 2006-07 fiscal year, the department may not approve any
rate adjustment for a work activity program that would result in an
increase in the rate to be paid to the vendor from the rate that is
in effect on or after
July 1, 2006, unless the regional center demonstrates that the rate
adjustment is necessary to protect the consumers' health and safety
and the department has granted prior written authorization.
SEC. 55. Section 4691.8 is added to the Welfare and Institutions
Code, to read:
4691.8. (a) Notwithstanding any other provision of law or
regulation, and to the extent funds are appropriated in the annual
Budget Act for this purpose, the department may provide a rate
increase for the purpose of enhancing wages for direct care staff in
day programs and in work activity programs, as defined in subdivision
(e) of Section 4851, and in look-alike programs, that meet any of
the following criteria:
(1) Provide a majority of their services and supports in
integrated community settings.
(2) Are day programs that are converting to integrated community
settings.
(3) Are work activity programs that are converting to supported
work programs.
(b) The department may approve a temporary rate increase for a
program that is converting pursuant to paragraph (2) or (3) of
subdivision (a). A program shall not be eligible for a permanent rate
increase pursuant to this section unless it meets the criteria
established in paragraph (1) of subdivision (a).
(c) A rate increase provided pursuant to paragraph (1) of
subdivision (a) to existing programs shall be effective not more than
60 days following the adoption of the Budget Act that appropriates
the necessary funding.
(d) Prior to implementation of this section, the department shall
consult with stakeholders, including various provider organizations,
the regional centers, and all other interested parties.
(e) The department shall provide the Legislature, by April 1,
2007, with a description of how this section has been implemented,
along with the following information:
(1) The number of day programs and work activity centers receiving
an enhanced rate, by regional center.
(2) The number of program conversions, by regional center.
(3) The percentage of rate increase provided to programs.
(4) The effect of the rate increase on direct care staff wages.
SEC. 56. Section 4694 is added to the Welfare and Institutions
Code, to read:
4694. Commencing July 1, 2006, all regional center vendors who
are qualified providers under Title XIX of the federal Social
Security Act (42 U.S.C. Sec. 1396 et seq.) and are serving
individuals enrolled under the Home- and Community-based Services
Waiver program for persons with developmental disabilities, shall
ensure that billing information provided to regional centers
identifies each individual consumer and, for each consumer, the
specific dates of service, location of service, service unit, unit
costs, and other information necessary to support billing under the
home- and community-based services waiver. Regional centers shall
also ensure that their contractual and other billing and payment
arrangements with providers require the provision of any information
necessary to support billing under the Home- and Community-based
Services Waiver program. Resources provided to regional centers,
pursuant to the Budget Act of 2006 and following budgets, to
implement this provision shall be allocated to the regional centers
only until implementation of a statewide electronic data system that
collects the billing information necessary to support billing under
the Home- and Community-based Services Waiver program.
SEC. 57. Section 4781.5 of the Welfare and Institutions Code is
amended to read:
4781.5. (a) For the 2006-07 fiscal year only, a regional center
may not expend any purchase of service funds for the startup of any
new program unless one of the following criteria is met:
(1) The expenditure is necessary to protect the consumer's health
or safety or because of other extraordinary circumstances.
(2) The program to be developed promotes and provides integrated
supported work options for individuals or groups of no more than
three consumers.
(3) The program to be developed promotes and provides integrated
social, civic, volunteer, or recreational activities.
(b) Notwithstanding subdivision (a), a regional center may approve
grants to current providers to engage in new or expanded employment
activities that result in greater integration, conversion from
sheltered to supported work environments, self-employment, and
increased consumer participation in the federal Ticket to Work
program.
(c) Startup contracts for programs funded under this section shall
be outcome-based.
(d) The department shall develop criteria by which regional
centers shall approve grants, and shall provide prior written
authorization for the expenditures under this section.
(e) This section shall not apply to any of the following:
(1) The purchase of services funds allocated as part of the
department's community placement plan process.
(2) Expenditures for the startup of new programs made pursuant to
a contract entered into before July 1, 2002.
SEC. 58. Section 4860 of the Welfare and Institutions Code is
amended to read:
4860. (a) (1) The hourly rate for supported employment services
provided to consumers receiving individualized services shall be
thirty-four dollars and twenty-four cents ($34.24).
(2) Job coach hours spent in travel to consumer worksites may be
reimbursable for individualized services only when the job coach
travels from the vendor's headquarters to the consumer's worksite or
from one consumer's worksite to another, and only when the travel is
one way.
(b) The hourly rate for group services shall be thirty-four
dollars and twenty-four cents ($34.24), regardless of the number of
consumers served in the group. Consumers in a group shall be
scheduled to start and end work at the same time, unless an exception
that takes into consideration the consumer's compensated work
schedule is approved in advance by the regional center. The
department, in consultation with stakeholders, shall adopt
regulations to define the appropriate grounds for granting these
exceptions. When the number of consumers in a supported employment
placement group drops to fewer than the minimum required in
subdivision (r) of Section 4851 the regional center may terminate
funding for the group services in that group, unless, within 90 days,
the program provider adds one or more regional center, or Department
of Rehabilitation funded supported employment consumers to the
group.
(c) Job coaching hours for group services shall be allocated on a
prorated basis between a regional center and the Department of
Rehabilitation when regional center and Department of Rehabilitation
consumers are served in the same group.
(d) When Section 4855 applies, fees shall be authorized for the
following:
(1) A four hundred dollar ($400) fee shall be paid to the program
provider upon intake of a consumer into a supported employment
program. No fee shall be paid if that consumer completed a supported
employment intake process with that same supported employment program
within the previous 12 months.
(2) An eight hundred dollar ($800) fee shall be paid upon
placement of a consumer in an integrated job, except that no fee
shall be paid if that consumer is placed with another consumer or
consumers assigned to the same job coach during the same hours of
employment.
(3) An eight hundred dollar ($800) fee shall be paid after a
90-day retention of a consumer in a job, except that no fee shall be
paid if that consumer has been placed with another consumer or
consumers, assigned to the same job coach during the same hours of
employment.
(e) Notwithstanding paragraph (4) of subdivision (a) of Section
4648 the regional center shall pay the supported employment program
rates established by this section.
SEC. 59. Section 5675.2 of the Welfare and Institutions Code is
amended to read:
5675.2. (a) There is hereby created in the State Treasury the
Licensing and Certification Fund, Mental Health, from which money,
upon appropriation by the Legislature in the Budget Act, shall be
expended by the State Department of Mental Health to fund
administrative and other activities in support of the department's
Licensing and Certification Program.
(b) Commencing January 1, 2005, each new and renewal application
for a license to operate a mental health rehabilitation center shall
be accompanied by an application or renewal fee.
(c) The amount of the fees shall be determined and collected by
the State Department of Mental Health, but the total amount of the
fees collected shall not exceed the actual costs of licensure and
regulation of the centers, including, but not limited to, the costs
of processing the application, inspection costs, and other related
costs.
(d) Each license or renewal issued pursuant to this chapter shall
expire 12 months from the date of issuance. Application for renewal
of the license shall be accompanied by the necessary fee and shall be
filed with the department at least 30 days prior to the expiration
date. Failure to file a timely renewal may result in expiration of
the license.
(e) License and renewal fees collected pursuant to this section
shall be deposited into the Licensing and Certification Fund, Mental
Health.
(f) Fees collected by the department pursuant to this section
shall be expended by the department for the purpose of ensuring the
health and safety of all individuals providing care and supervision
by licensees and to support activities of the Licensing and
Certification Program, including, but not limited to, monitoring
facilities for compliance with applicable laws and regulations.
(g) The department may make additional charges to the facilities
if additional visits are required to ensure that corrective action is
taken by the licensee.
SEC. 60. Section 14007.2 is added to the Welfare and Institutions
Code, to read:
14007.2. (a) Any individual who is otherwise eligible for
Medi-Cal services, but who does not meet the documentation
requirements described in subdivision (e) of Section 14011.2, shall
be eligible only for the scope of services made available to aliens
under subdivision (d) of Section 14007.5, and Sections 14007.65 and
14007.7.
(b) To the extent that federal financial participation is
available to fund services described under subdivision (a), the
department shall file all necessary state plan amendments to obtain
that funding.
SEC. 61. Section 14011.2 of the Welfare and Institutions Code, as
added by Section 66 of Chapter 722 of the Statutes of 1992, is
amended to read:
14011.2. (a) The department shall require that each applicant for
or beneficiary of Medi-Cal, including a child, who is not a
recipient of aid under the provisions of Chapter 2 (commencing with
Section 11200) or Chapter 3 (commencing with Section 12000) shall
provide his or her social security account number, or numbers, if he
or she has more than one such number.
(b) The requirement for a social security account number shall be
a condition of eligibility only for the applicant who is seeking or
the beneficiary who is receiving (1) full-scope medical benefits or
(2), pursuant to Section 14007.5, restricted medical benefits
(emergency and pregnancy-related services only), and, in either case,
who declares, as required in subdivision (d), that he or she is a
citizen or national of the United States, and, if he or she is not a
citizen or national of the United States, that he or she has
satisfactory immigration status.
(c) The requirement for a social security account number shall not
be a condition of eligibility for the applicant who is seeking or
the beneficiary who is receiving, pursuant to Section 14007.5,
restricted medical benefits (emergency and pregnancy-related services
only), and who has not made the declaration, as required in
subdivision (d), that he or she is not a citizen or national of the
United States, and, if he or she is not a citizen or national of the
United States, that he or she does not have satisfactory immigration
status.
(d) Every applicant or beneficiary or, in the case of a child, by
the child's caretaker relative or legal guardian on his or her behalf
shall declare, under penalty of perjury, that he or she is, or is
not any of the following:
(1) A citizen of the United States.
(2) A national of the United States.
(3) An alien who has satisfactory immigration status.
(e) (1) Notwithstanding Section 50301.1 of Title 22 of the
California Code of Regulations, an individual who declares to be a
citizen or national of the United States in accordance with Section
1903(i)(22) of the federal Social Security Act (42 U.S.C. Sec. 1396b
(i)(22)) shall present satisfactory documentary evidence of
citizenship or nationality in compliance with Section 1903(x) (42
U.S.C. Sec. 1396b(x) of the federal Social Security Act). Except as
otherwise provided in Section 14007.2, no services shall be available
under this chapter for an individual who fails to comply with the
documentation requirements of this section.
(2) (A) The documentation required pursuant to paragraph (1) shall
be provided once by each individual, as follows:
(i) During the initial application process for applicants.
(ii) During the redetermination process for existing
beneficiaries.
(B) If the documentation is obtained from a beneficiary, the
county shall maintain a copy of the documentation in the case file of
the beneficiary, and shall not request this documentation again.
(C) If electronic verification is used, a record of the
documentation shall be maintained in the case record and shall not be
requested again.
(D) Once the required documentation has been obtained by the
county, the beneficiary shall not be required to provide it again,
even if he or she is transferring to or applying in a new county.
(3) To the extent that federal financial participation is
available, the department shall provide for exceptions or
alternatives to the documentation requirements imposed by this
subdivision as a means of providing individuals with increased
flexibility and ability to provide satisfactory documentary evidence
within a reasonable period of time. These exceptions or alternatives
may include, but shall not be limited to, using an expanded list of
acceptable documents, relying on electronic data matches for birth
certificates, relying on a sworn affidavit of citizenship with
respect to an individual who can demonstrate good cause for his or
her inability or other failure to provide the required documentation,
and relying on other information that may be available
electronically.
(4) (A) To the extent that federal financial participation is
available, the department shall rely on the eligibility
determinations for the CalWORKs program or the Aid to Families with
Dependent Children-Foster Care program as meeting the requirements of
this section.
(B) To the extent that federal financial participation is
available, an individual shall be deemed to have met the
documentation requirements of this subdivision if the individual has
been determined to be eligible for supplemental security income
pursuant to Title XVI of the Social Security Act (42 U.S.C. Sec. 1601
et seq.).
(5) The following provisions shall apply to the extent that
federal financial participation is available:
(A) If an individual cooperates in the effort to obtain and
present the documentation required under this subdivision, the
individual shall be given as much time as is allowed by federal law
and policy to present that documentation.
(B) During the time period described in subparagraph (A), an
applicant shall receive the scope of Medi-Cal benefits for which the
applicant is otherwise eligible.
(6) To the extent that federal financial participation is
available, the county shall do all of the following to assist an
individual in obtaining and presenting the documentation required
under this subdivision:
(A) For an applicant who does not present the required
documentation at the time of application, the county, during the time
period described in subparagraph (A) of paragraph (5), shall assist
the applicant in obtaining that documentation.
(B) For a current beneficiary who has not yet documented his or
her citizenship, the county shall do the following:
(i) If, at the time of annual redetermination, the beneficiary
returns the annual redetermination form and, but for the failure to
present the required documentation, continued eligibility could be
established, the county shall do the following:
(I) Review county eligibility files and records, and the Medi-Cal
Eligibility Data System, to access those documents. This review shall
include a review of any CalWORKs or food stamp files that may exist
for the beneficiary.
(II) Attempt to reach the beneficiary by telephone to advise the
beneficiary as to the need to obtain and present the required
documentation.
(III) If the beneficiary fails to respond to the telephone contact
or present the required documents, send a second form to the
beneficiary that highlights the documentation being requested and
informs the beneficiary to contact the county. The form shall be
written in a simple, clear, consumer-friendly manner, and shall
explain why the documentation is necessary.
(IV) If the beneficiary fails to contact the county, the county
shall make another attempt to reach the beneficiary by telephone to
advise the beneficiary of the need to obtain and present the required
documentation.
(ii) Document in the case file any efforts made to contact and
advise the beneficiary as to the need to obtain and present the
required documentation.
(C) If a beneficiary fails to present the required documentation
after the process required under clause (i), the county shall send a
10-day notice of action to indicate that the beneficiary's benefits
are reduced to those made available under Section 14007.2.
(7) (A) Any benefits provided in accordance with subparagraph (B)
of paragraph (5) shall terminate if any of the following occurs:
(i) The individual does not obtain and present the required
documentation within the time period provided in subparagraph (A) of
paragraph (5).
(ii) The documentation is received by the county and the county
has made a final determination of eligibility.
(B) The termination of Medi-Cal benefits under this paragraph
shall occur without the necessity of further review or determination
by the department. This shall not affect an individual's right to a
hearing with respect to the denial of the application or termination
of eligibility resulting from the annual eligibility redetermination.
(8) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department shall implement this subdivision by means of an all county
letter or similar instruction without taking regulatory action.
Within three years from the date that this subdivision becomes
effective, the department shall adopt regulations in accordance with
the requirements of Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code.
(9) The department shall notify and consult with advocates,
providers, counties, and health plans in implementing, interpreting,
or making specific this subdivision.
(10) The department shall file all necessary state plan amendments
to implement the requirements of this subdivision. Upon filing any
state plan amendment, the department shall provide the appropriate
fiscal committees of the Legislature with a copy of the state plan
amendment.
(11) If any part of this subdivision is in conflict with or does
not comply with federal law, the subdivision shall be implemented
only to the extent that federal law permits. Any part that is in
conflict with or does not comply with federal law shall be severable
from the remaining portions of this subdivision.
SEC. 62. Section 14043.46 of the Welfare and Institutions Code is
amended to read:
14043.46. (a) Notwithstanding any other provision of law, on the
effective date of the act adding this section, the department may
implement a one-year moratorium on the certification and enrollment
into the Medi-Cal program of new adult day health care centers on a
statewide basis or within a geographic area.
(b) The moratorium shall not apply to the following:
(1) Programs of All-Inclusive Care for the Elderly (PACE)
established pursuant to Chapter 8.75 (commencing with Section 14590).
(2) An organization that currently holds a designation as a
federally qualified health center as defined in Section 1396d(l)(2)
of Title 42 of the United States Code.
(3) An organization that currently holds a designation as a
federally qualified rural health clinic as defined in Section 1396d
(l)(1) of Title 42 of the United States Code.
(4) An applicant with the physical location of the center in an
unserved area, which is defined as a county having no licensed and
certified adult day health care center within its geographic
boundary.
(5) Commencing May 1, 2006, an applicant for certification that
meets all of the following:
(A) Is serving persons discharged into community housing from a
nursing facility operated by the City and County of San Francisco.
(B) Has submitted, after December 31, 2005, but prior to February
1, 2006, an application for certification that has not been denied.
(C) Meets all criteria for certification imposed under this
article and is licensed as an adult day health care center pursuant
to Chapter 3.3 (commencing with Section 1570) of Division 2 of the
Health and Safety Code.
(6) An applicant that is requesting expansion or relocation, or
both, that has been Medi-Cal certified as an adult day health care
center for at least four years, is expanding or relocating within the
same county, and that meets one of the following population-based
criteria:
(A) The county is ranked number one or two for having the highest
ratio of persons over 65 years of age receiving Medi-Cal benefits.
(B) The county is ranked number one or two for having the highest
ratio of persons over 85 years of age residing in the county.
(C) The county is ranked number one or two for having the greatest
ratio of persons over 65 years of age living in poverty.
(7) An applicant for certification that is currently licensed and
located in a county with a population that exceeds 9,000,000 and
meets the following criteria:
(A) The applicant has identified a special population of regional
center consumers whose individual program plan calls for the
specialized health and social services that are uniquely provided
within the adult day health care center, in order to prevent
deterioration of the special population's health status.
(B) The referring regional center submits a letter to the Director
of Health Services supporting the applicant for certification as an
adult day health care provider for this special population.
(C) The applicant is currently providing services to the special
population as a vendor of the referring regional center.
(D) The participants in the center are clients of the referring
regional center and are not residing in a health facility licensed
pursuant to subdivision (c), (d), (g), (h), or (k) of Section 1250 of
the Health and Safety Code.
(c) The moratorium shall not prohibit the department from
approving a change of ownership, relocation, or increase in capacity
for an adult day health care center if the following conditions are
met:
(1) For an application to change ownership, the adult day health
care center meets all of the following conditions:
(A) Has been licensed and certified prior to the effective date of
this section.
(B) Has a license in good standing.
(C) Has a record of substantial compliance with certification laws
and regulations.
(D) Has met all requirements for the change application.
(2) For an application to relocate an existing facility, the
relocation center must meet all of the conditions of paragraph (1)
and both of the following conditions:
(A) Must be located in the same county as the existing licensed
center.
(B) Must be licensed for the same capacity as the existing
licensed center, unless the relocation center is located in an
underserved area, which is defined as a county having 2 percent or
fewer Medi-Cal beneficiaries over the age of 65 years using adult day
health care services, based on 2002 calendar year Medi-Cal
utilization data.
(3) For an application to increase the capacity of an existing
facility, the center must meet all of the conditions of paragraph (1)
and must be located in an underserved area, which is defined as a
county having 2 percent or fewer Medi-Cal beneficiaries over the age
of 65 years using adult day health care services, based on 2002
calendar year Medi-Cal utilization data.
(d) Following the first 180 days of the moratorium period, the
department may make exceptions to the moratorium for new adult day
health care centers that are located in underserved areas if the
center's application was on file with the department on or before the
effective date of the act adding this section. In order to apply for
this exemption, an applicant or licensee must meet all of the
following criteria:
(1) The applicant has control of a facility, either by ownership
or lease agreement, that will house the adult day health care center,
has provided to the department all necessary documents and fees, and
has completed and submitted all required fingerprinting forms to the
department.
(2) The physical location of the applicant's or licensee's adult
day health care center is in an underserved area, which is defined as
a county having 2 percent or fewer Medi-Cal beneficiaries over the
age of 65 years using adult day health care services, based on 2002
calendar year Medi-Cal utilization data.
(e) During the period of the moratorium, a licensee or applicant
that meets the criteria for an exemption as defined in subdivision
(d) may submit a written request for an exemption to the director.
(f) If the director determines that a new adult day health care
licensee or applicant meets the exemption criteria, the director may
certify the licensee or applicant, once licensed, for participation
in the Medi-Cal program.
(g) The director may extend this moratorium, if necessary, to
coincide with the implementation date of the adult day health care
waiver.
(h) The authority granted in this section shall not be
interpreted as a limitation on the authority granted to the
department in any other section.
SEC. 63. Section 14067.3 is added to the Welfare and Institutions
Code, to read:
14067.3. (a) (1) The department may maintain an allocation
program for the management and funding of county outreach and
enrollment plans to enroll and retain eligible children in the
Medi-Cal program and the Healthy Families Program.
(2) Notwithstanding any other provision of law, and in a manner
that the director shall provide, the department may allocate an
amount to fund county outreach and enrollment plans identified in
this section.
(b) (1) The sum of three million dollars ($3,000,000) in the
2006-07 fiscal year, and thereafter adjusted proportionately on a pro
rata basis contingent upon the annual appropriation, but not less
than two million dollars ($2,000,000), shall be set aside, from the
annual allocation for purposes of this section, for counties
identified in subdivision (d).
(2) Notwithstanding paragraph (1), the total of all county
allocations made pursuant to this section shall not exceed the annual
appropriation for the implementation of this section.
(c) The director shall make allocations to not more than 20
counties that have the highest number of children who appear to be
eligible for the Medi-Cal program or the Healthy Families Program, as
determined by the director, but who are not currently enrolled in
either program, and the highest number of Medi-Cal program and
Healthy Families Program cases for children. This number shall be
weighted to emphasize those who appear eligible, but are not
currently enrolled in the programs.
(d) With funds set aside under paragraph (1) of subdivision (b),
the director shall make allocations to those counties that have an
existing infrastructure for outreach, enrollment, retention, and
utilization, and that can demonstrate they have well established and
documented county coalitions for children's coverage with
organizations such as community-based organizations, schools,
clinics, labor organizations, and other safety net providers in place
for at least 12 months.
(e) (1) To obtain an allocation authorized under this section, a
county shall submit an allocation plan, which shall include an
outreach and enrollment plan, as outlined in paragraph (2). The
director shall establish the procedures and format for submission to
the department of all county allocation plans.
(2) The following shall constitute the minimum components required
of a county outreach and enrollment plan:
(A) An active collaboration with a wide range of organizations,
such as community-based organizations, schools, clinics, labor
organizations, and other safety net providers.
(B) A streamlined application assistance process.
(C) Establishment of an oversight, performance management, and
review program to ensure that the outreach and enrollment plan
submitted by the county is properly implemented and administered.
(D) A description of each of the following:
(i) The amount of the current funding and funding source for
application, enrollment, retention, and utilization activities.
(ii) The current application, enrollment, retention, and
utilization activities.
(iii) How the allocation funds awarded under this section will be
used to supplement and not supplant existing application, enrollment,
retention, and utilization activities.
(E) A detailed proposed budget of all expenditures for the
relevant fiscal year or years for the county's outreach and
enrollment plan activities, expenses, services, materials, and
support.
(f) Counties receiving an allocation under this section shall
provide reports to the department, as determined by the department,
on the progress made in achieving the objectives of the allocation
plan.
(g) (1) The funds allocated under this section shall be used only
for outreach, enrollment, retention, and utilization. The funds
allocated under this section may supplement, but shall not supplant,
existing local, state, and foundation funding of county outreach,
enrollment, retention, and utilization activities. Notwithstanding
Section 10744, the department may recoup or withhold all or part of a
county's allocation for failure to comply with the standards set
forth in the county's outreach and enrollment plan upon which the
allocation was based.
(2) Notwithstanding any other provision in this section, any
acquisitions made with funds allocated under this section shall be
made in compliance with federal law.
(h) Reimbursements for costs incurred under the allocation plan
authorized under this section shall be made in arrears and in a
manner as provided by the director. The allocations may be used only
to fund activities provided in each of the designated fiscal years
and in accordance with the county's approved outreach and enrollment
plan and budget for the fiscal year.
(i) As authorized by the director, on a case by case basis, funds
allocated pursuant to this section may be used to support automated
enrollment of children in the Medi-Cal program or the Healthy
Families Program. Funds under this subdivision shall further the goal
of increasing the enrollment of uninsured children, as well as
increasing the retention of children, in the Medi-Cal program and
Healthy Families Program in the same fiscal year for which the funds
are allocated.
(j) The department and the Managed Risk Medical Insurance Board
shall seek approval of any amendments to the state plan necessary to
implement this section for purposes of funding under Titles XIX and
XXI of the federal Social Security Act (42 U.S.C. Secs. 1396 et seq.
and 1397aa et seq., respectively). This section shall be implemented
only when federal approvals have been obtained and only to the extent
federal financial participation is available.
(k) The department shall reimburse a county pursuant to this
section in lieu of commencing a cooperative agreement or contract
with a county for the operation of an outreach program.
(l) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement, interpret, or make specific this section by
means of all county letters, provider bulletins, or similar
instructions.
(m) For the purposes of this section, "county outreach and
enrollment plan" means a county outreach program designed to identify
and enroll children who are eligible either for the Healthy Families
Program or the Medi-Cal program, but are not currently enrolled in
either program, and to facilitate the retention of eligible children
currently enrolled in these programs.
SEC. 64. Section 14068 is added to the Welfare and Institutions
Code, to read:
14068. In conducting outreach activities for the enrollment of
special needs populations into a Medi-Cal managed care program, the
department and its contractors, as deemed applicable by the
department, shall work with state, local, and regional organizations
with the ability to target low-income seniors and individuals with
disabilities in the communities where they live. This shall include,
but not be limited to, all applicable state departments that serve
these individuals, regional centers, seniors' organizations, local
health consumer centers, and other consumer-focused organizations
that are engaging in providing assistance to this population.
SEC. 65. Section 14105.33 of the Welfare and Institutions Code is
amended to read:
14105.33. (a) The department may enter into contracts with
manufacturers of single-source and multiple-source drugs, on a bid or
nonbid basis, for drugs from each major therapeutic category, and
shall maintain a list of those drugs for which contracts have been
executed.
(b) (1) Contracts executed pursuant to this section shall be for
the manufacturer's best price, as defined in Section 14105.31, which
shall be specified in the contract, and subject to agreed-upon price
escalators, as defined in that section. The contracts shall provide
for an equalization payment amount, as defined in Section 14105.31,
to be remitted to the department quarterly. The department shall
submit an invoice to each manufacturer for the equalization payment
amount, including supporting utilization data from the department's
prescription drug paid claims tapes within 30 days of receipt of the
Centers for Medicare and Medicaid Services' file of manufacturer
rebate information. In lieu of paying the entire invoiced amount, a
manufacturer may contest the invoiced amount pursuant to procedures
established by the federal Centers for Medicare and Medicaid Services'
Medicaid Drug Rebate Program Releases or regulations by mailing a
notice, that shall set forth its grounds for contesting the invoiced
amount, to the department within 38 days of the department's mailing
of the state invoice and supporting utilization data. For purposes of
state accounting practices only, the contested balance shall not be
considered an accounts receivable amount until final resolution of
the dispute pursuant to procedures established by the federal Centers
for Medicare and Medicaid Services' Medicaid Drug Rebate Program
Releases or regulations that results in a finding of an underpayment
by the manufacturer. Manufacturers may request, and the department
shall timely provide, at cost, Medi-Cal provider level drug
utilization data, and other Medi-Cal utilization data necessary to
resolve a contested department-invoiced rebate amount.
(2) The department shall provide for an annual audit of
utilization data used to calculate the equalization amount to verify
the accuracy of that data. The findings of the audit shall be
documented in a written audit report to be made available to
manufacturers within 90 days of receipt of the report from the
auditor. Any manufacturer may receive a copy of the audit report upon
written request. Contracts between the department and manufacturers
shall provide for any equalization payment adjustments determined
necessary pursuant to an audit.
(3) Utilization data used to determine an equalization payment
amount shall exclude data from both of the following:
(A) Health maintenance organizations, as defined in Section 300e
(a) of Title 42 of the United States Code, including those
organizations that contract under Section 1396b(m) of Title 42 of the
United States Code.
(B) Capitated plans that include a prescription drug benefit in
the capitated rate, and that have negotiated contracts for rebates or
discounts with manufacturers.
(4) Utilization data used to determine an equalization payment
amount shall include data from all programs that qualify for federal
drug rebates pursuant to Section 1927 of the federal Social Security
Act (42 U.S.C. Sec. 1396r-8) or that otherwise qualify for federal
funds under Title XIX of the federal Social Security Act (42 U.S.C.
Sec. 1396 et seq.) pursuant to the Medicaid state plan or waivers.
(c) In order that Medi-Cal beneficiaries may have access to a
comprehensive range of therapeutic agents, the department shall
ensure that there is representation on the list of contract drugs in
all major therapeutic categories. Except as provided in subdivision
(a) of Section 14105.35, the department shall not be required to
contract with all manufacturers who negotiate for a contract in a
particular category. The department shall ensure that there is
sufficient representation of single-source and multiple-source drugs,
as appropriate, in each major therapeutic category.
(d) The department shall select the therapeutic categories to be
included on the list of contract drugs, and the order in which it
seeks contracts for those categories. The department may establish
different contracting schedules for single-source and multiple-source
drugs within a given therapeutic category.
(e) (1) In order to fully implement subdivision (d), the
department shall, to the extent necessary, negotiate or renegotiate
contracts to ensure there are as many single-source drugs within each
therapeutic category or subcategory as the department determines
necessary to meet the health needs of the Medi-Cal population. The
department may determine in selected therapeutic categories or
subcategories that no single-source drugs are necessary because there
are currently sufficient multiple-source drugs in the therapeutic
category or subcategory on the list of contract drugs to meet the
health needs of the Medi-Cal population. However, in no event shall a
beneficiary be denied continued use of a drug which is part of a
prescribed therapy in effect as of September 2, 1992, until the
prescribed therapy is no longer prescribed.
(2) In the development of decisions by the department on the
required number of single-source drugs in a therapeutic category or
subcategory, and the relative therapeutic merits of each drug in a
therapeutic category or subcategory, the department shall consult
with the Medi-Cal Contract Drug Advisory Committee. The committee
members shall communicate their comments and recommendations to the
department within 30 business days of a request for consultation, and
shall disclose any associations with pharmaceutical manufacturers or
any remuneration from pharmaceutical manufacturers.
(f) In order to achieve maximum cost savings, the Legislature
declares that an expedited process for contracts under this section
is necessary. Therefore, contracts entered into on a nonbid basis
shall be exempt from Chapter 2 (commencing with Section 10290) of
Part 2 of Division 2 of the Public Contract Code.
(g) In no event shall a beneficiary be denied continued use of a
drug that is part of a prescribed therapy in effect as of September
2, 1992, until the prescribed therapy is no longer prescribed.
(h) Contracts executed pursuant to this section shall be
confidential and shall be exempt from disclosure under the California
Public Records Act (Chapter 3.5 (commencing with Section 6250) of
Division 7 of Title 1 of the Government Code).
(i) The department shall provide individual notice to Medi-Cal
beneficiaries at least 60 calendar days prior to the effective date
of the deletion or suspension of any drug from the list of contract
drugs. The notice shall include a description of the beneficiary's
right to a fair hearing and shall encourage the beneficiary to
consult a physician to determine if an appropriate substitute
medication is available from Medi-Cal.
(j) In carrying out the provisions of this section, the department
may contract either directly, or through the fiscal intermediary,
for pharmacy consultant staff necessary to initially accomplish the
treatment authorization request reviews.
(k) (1) Manufacturers shall calculate and pay interest on late or
unpaid rebates. The interest shall not apply to any prior period
adjustments of unit rebate amounts or department utilization
adjustments.
(2) For state rebate payments, manufacturers shall calculate and
pay interest on late or unpaid rebates for quarters that begin on or
after the effective date of the act that added this subdivision.
(3) Following final resolution of any dispute pursuant to
procedures established by the federal Centers for Medicare and
Medicaid Services' Medicaid Drug Rebate Program Releases or
regulations regarding the amount of a rebate, any underpayment by a
manufacturer shall be paid with interest calculated pursuant to
subdivisions (m) and (n), and any overpayment, together with interest
at the rate calculated pursuant to subdivisions (m) and (n), shall
be credited by the department against future rebates due.
(l) Interest pursuant to subdivision (k) shall begin accruing 38
calendar days from the date of mailing of the invoice, including
supporting utilization data sent to the manufacturer. Interest shall
continue to accrue until the date of mailing of the manufacturer's
payment.
(m) Except as specified in subdivision (n), interest rates and
calculations pursuant to subdivision (k) for medicaid rebates and
state rebates shall be identical and shall be determined by the
federal Centers for Medicare and Medicaid Services' Medicaid Drug
Rebate Program Releases or regulations.
(n) If the date of mailing of a state rebate payment is 69 days or
more from the date of mailing of the invoice, including supporting
utilization data sent to the manufacturer, the interest rate and
calculations pursuant to subdivision (k) shall be as specified in
subdivision (m), however the interest rate shall be increased by 10
percentage points. This subdivision shall apply to payments for
amounts invoiced for any quarters that begin on or after the
effective date of the act that added this subdivision.
(o) If the rebate payment is not received, the department shall
send overdue notices to the manufacturer at 38, 68, and 98 days after
the date of mailing of the invoice, and supporting utilization data.
If the department has not received a rebate payment, including
interest, within 180 days of the date of mailing of the invoice,
including supporting utilization data, the manufacturer's contract
with the department shall be deemed to be in default and the contract
may be terminated in accordance with the terms of the contract. For
all other manufacturers, if the department has not received a rebate
payment, including interest, within 180 days of the date of mailing
of the invoice, including supporting utilization data, all of the
drug products of those manufacturers shall be made available only
through prior authorization effective 270 days after the date of
mailing of the invoice, including utilization data sent to
manufacturers.
(p) If the manufacturer provides payment or evidence of payment to
the department at least 40 days prior to the proposed date the drug
is to be made available only through prior authorization pursuant to
subdivision (o), the department shall terminate its actions to place
the manufacturers' drug products on prior authorization.
(q) The department shall direct the state's fiscal intermediary to
remove prior authorization requirements imposed pursuant to
subdivision (o) and notify providers within 60 days after payment by
the manufacturer of the rebate, including interest. If a contract was
in place at the time the manufacturers' drugs were placed on prior
authorization, removal of prior authorization requirements shall be
contingent upon good faith negotiations and a signed contract with
the department.
(r) A beneficiary may obtain drugs placed on prior authorization
pursuant to subdivision (o) if the beneficiary qualifies for
continuing care status. To be eligible for continuing care status, a
beneficiary must be taking the drug when its manufacturer is placed
on prior authorization status. Additionally, the department shall
have received a claim for the drug with a date of service that is
within 100 days prior to the date the manufacturer was placed on
prior authorization.
(s) A beneficiary may remain eligible for continuing care status,
provided that a claim is submitted for the drug in question at least
every 100 days and the date of service of the claim is within 100
days of the date of service of the last claim submitted for the same
drug.
(t) Drugs covered pursuant to Sections 14105.43 and 14133.2 shall
not be subject to prior authorization pursuant to subdivision (o),
and any other drug may be exempted from prior authorization by the
department if the director determines that an essential need exists
for that drug, and there are no other drugs currently available
without prior authorization that meet that need.
(u) It is the intent of the Legislature in enacting subdivisions
(k) to (t), inclusive, that the department and manufacturers shall
cooperate and make every effort to resolve rebate payment disputes
within 90 days of notification by the manufacturer to the department
of a dispute in the calculation of rebate payments.
SEC. 66. Section 14105.48 of the Welfare and Institutions Code is
amended to read:
14105.48. (a) The department shall establish a list of covered
services and maximum allowable reimbursement rates for durable
medical equipment as defined in Section 51160 of Title 22 of the
California Code of Regulations and the list shall be published in
provider manuals. The list shall specify utilization controls to be
applied to each type of durable medical equipment.
(b) Reimbursement for durable medical equipment, except
wheelchairs, wheelchair accessories, and speech-generating devices
and related accessories, shall be the lesser of (1) the amount billed
pursuant to Section 51008.1 of Title 22 of the California Code of
Regulations, (2) an amount that does not exceed 80 percent of the
lowest maximum allowance for California established by the federal
Medicare Program for the same or similar item or service, or (3) the
guaranteed acquisition cost negotiated by means of the contracting
process provided for pursuant to Section 14105.3 plus a percentage
markup to be established by the department.
(c) Reimbursement for wheelchairs, wheelchair accessories, and
speech-generating devices and related accessories shall be the lesser
of (1) the amount billed pursuant to Section 51008.1 of Title 22 of
the California Code of Regulations, (2) an amount that does not
exceed 100 percent of the lowest maximum allowance for California
established by the federal Medicare Program for the same or similar
item or service, or (3) the guaranteed acquisition cost negotiated by
means of the contracting process provided for pursuant to Section
14105.3 plus a percentage markup to be established by the department.
(d) Reimbursement for all durable medical equipment billed to the
Medi-Cal program utilizing codes with no specified maximum allowable
rate shall be the lesser of (1) the amount billed pursuant to Section
51008.1 of Title 22 of the California Code of Regulations, (2) the
guaranteed acquisition cost negotiated by means of the contracting
process provided for pursuant to Section 14105.3 plus a percentage
markup to be established by the department, (3) the actual
acquisition cost plus a markup to be established by the department,
(4) the manufacturer's suggested retail purchase price on June 1,
2006, and documented by a printed catalog or a hard copy of an
electronic catalog page showing the price on that date, reduced by a
percentage discount not to exceed 20 percent, or not to exceed 15
percent for wheelchairs and wheelchair accessories if the provider
employs or contracts with a qualified rehabilitation professional, as
defined in paragraph (3) of subdivision (c) of Section 14105.485, or
(5) a price established through targeted product-specific cost
containment provisions developed with providers.
(e) Reimbursement for all durable medical equipment supplies and
accessories billed to the Medi-Cal program shall be the lesser of (1)
the amount billed pursuant to Section 51008.1 of Title 22 of the
California Code of Regulations, or (2) the acquisition cost plus a 23
percent markup.
(f) Commencing January 1, 2007, reimbursement for oxygen delivery
systems and oxygen contents shall utilize national HCPCS codes, and
shall be the lesser of (1) the amount billed pursuant to Section
51008.1 of Title 22 of the California Code of Regulations, (2) an
amount that does not exceed 80 percent of the lowest maximum
allowance for California established by the federal Medicare Program
for the same or a similar item or service, or (3) the guaranteed
acquisition cost negotiated by means of the contracting process
provided for pursuant to Section 14105.3, plus a percentage markup to
be established by the department.
(g) Within six months of the effective date of the act that added
this subdivision, the department shall review utilization of services
and equipment resulting from the changes to this section made by
that act, and shall assess whether the changes are contributing to
inappropriate use of those services or equipment. If the department's
review finds an increase in inappropriate use of those services or
equipment, the Department of Finance shall notify the Joint
Legislative Budget Committee of the State Department of Health
Services' findings and recommended changes to ensure program
integrity.
(h) Any regulation in Division 3 of Title 22 of the California
Code of Regulations that contains provisions for reimbursement rates
for durable medical equipment shall be amended or repealed effective
for dates of service on or after the date of the act adding this
section.
(i) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of the Government Code, actions under this
section shall not be subject to the Administrative Procedure Act or
to the review and approval of the Office of Administrative Law.
(j) The department shall consult with interested parties and
appropriate stakeholders in implementing this section with respect to
all of the following:
(1) Notifying the provider representatives of the proposed change.
(2) Scheduling at least one meeting to discuss the change.
(3) Allowing for written input regarding the change.
(4) Providing advance notice on the implementation and effective
date of the change.
(k) The department may require providers of durable medical
equipment to appeal Medicare denials for dually eligible
beneficiaries as a condition of Medi-Cal payment.
SEC. 67. Section 14105.49 of the Welfare and Institutions Code is
amended to read:
14105.49. (a) (1) The department shall establish a list of
Healthcare Common Procedure Coding System (HCPCS) codes billable to
the Medi-Cal program and reimbursement rates, subject to Section
51319 of Title 22 of the California Code of Regulations, hearing
aids, and the list shall be published in the Medi-Cal Provider
Manual.
(2) The department may implement this section by provider manual
or bulletin. Notwithstanding the provisions of the Administrative
Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1
of Division 3 of the Government Code), actions of the department
under this section shall not be subject to the rulemaking provisions
of the Administrative Procedure Act or to the review and approval of
the Office of Administrative Law.
(b) The maximum reimbursement rate for hearing aids shall not
exceed the lesser of the following:
(1) The maximum allowable amount established by the department.
(2) The one-unit wholesale cost, plus a markup determined by the
department.
(3) The billed amount.
(4) The rate established by the department's contracting program.
(c) The maximum reimbursement rate for hearing aid supplies and
accessories shall not exceed the lesser of the following:
(1) The retail price.
(2) The wholesale cost, plus a markup determined by the
department.
(3) The billed amount.
(4) The rate established by the department's contracting program.
(d) The maximum reimbursement rate for molds or inserts shall not
exceed the lesser of the following:
(1) The maximum amount allowable established by the department.
(2) The billed amount.
(3) The rate established by the department's contracting program.
(e) The maximum reimbursement for repairs, subsequent to the
guarantee period, shall not exceed the lesser of the following:
(1) The invoice cost plus a markup determined by the department.
(2) The billed amount.
(3) The rate established by the department's contracting program.
SEC. 68. Section 14133.07 is added to the Welfare and Institutions
Code, to read:
14133.07. (a) Prior authorization for podiatric services provided
on an outpatient or inpatient basis shall not be required when all
of the following conditions are met:
(1) The services are provided by a doctor of podiatric medicine
acting within the scope of his or her practice.
(2) The services are related to trauma, infection management, pain
control, wound management, diabetic foot care, or limb salvage.
(3) The services are medically necessary.
(4) An urgent or emergency need for services exists at the time
the service is provided.
(5) The patient was referred to the doctor of podiatric medicine
by a physician.
(6) Prior authorization is not required for a physician providing
the same service.
(b) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement, interpret, or make specific this section by
means of all county letters, provider bulletins, or similar
instructions.
(c) This section shall become operative October 1, 2006.
SEC. 69. Section 14154 of the Welfare and Institutions Code is
amended to read:
14154. (a) The department shall establish and maintain a plan
whereby costs for county administration of the determination of
eligibility for benefits under this chapter will be effectively
controlled within the amounts annually appropriated for that
administration. The plan, to be known as the County Administrative
Cost Control Plan, shall establish standards and performance
criteria, including workload, productivity, and support services
standards, to which counties shall adhere. The plan shall include
standards for controlling eligibility determination costs that are
incurred by performing eligibility determinations at county
hospitals, or that are incurred due to the outstationing of any other
eligibility function. Except as provided in Section 14154.15,
reimbursement to a county for outstationed eligibility functions
shall be based solely on productivity standards applied to that
county's welfare department office. The plan shall be part of a
single state plan, jointly developed by the department and the State
Department of Social Services, in conjunction with the counties, for
administrative cost control for the California Work Opportunity and
Responsibility to Kids (CalWORKs), Food Stamp, and Medical Assistance
(Medi-Cal) programs. Allocations shall be made to each county and
shall be limited by and determined based upon the County
Administrative Cost Control Plan. In administering the plan to
control county administrative costs, the department shall not
allocate state funds to cover county cost overruns that result from
county failure to meet requirements of the plan. The department and
the State Department of Social Services shall budget, administer, and
allocate state funds for county administration in a uniform and
consistent manner.
(b) Nothing in this section, Section 15204.5, or Section 18906
shall be construed so as to limit the administrative or budgetary
responsibilities of the department in a manner that would violate
Section 14100.1, and thereby jeopardize federal financial
participation under the Medi-Cal program.
(c) The Legislature finds and declares that in order for counties
to do the work that is expected of them, it is necessary that they
receive adequate funding, including adjustments for reasonable annual
cost-of-doing-business increases. The Legislature further finds and
declares that linking appropriate funding for county Medi-Cal
administrative operations, including annual cost-of-doing-business
adjustments, with performance standards will give counties the
incentive to meet the performance standards and enable them to
continue to do the work they do on behalf of the state. It is
therefore the Legislature's intent to provide appropriate funding to
the counties for the effective administration of the Medi-Cal program
at the local level to ensure that counties can reasonably meet the
purposes of the performance measures as contained in this section.
(d) The department is responsible for the Medi-Cal program in
accordance with state and federal law. A county shall determine
Medi-Cal eligibility in accordance with state and federal law. If in
the course of its duties the department becomes aware of accuracy
problems in any county, the department shall, within available
resources, provide training and technical assistance as appropriate.
Nothing in this section shall be interpreted to eliminate any remedy
otherwise available to the department to enforce accurate county
administration of the program. In administering the Medi-Cal
eligibility process, each county shall meet the following performance
standards each fiscal year:
(1) Complete eligibility determinations as follows:
(A) Ninety percent of the general applications without applicant
errors and are complete shall be completed within 45 days.
(B) Ninety percent of the applications for Medi-Cal based on
disability shall be completed within 90 days, excluding delays by the
state.
(2) (A) The department shall establish best-practice guidelines
for expedited enrollment of newborns into the Medi-Cal program,
preferably with the goal of enrolling newborns within 10 days after
the county is informed of the birth. The department, in consultation
with counties and other stakeholders, shall work to develop a process
for expediting enrollment for all newborns, including those born to
mothers receiving CalWORKs assistance.
(B) Upon the development and implementation of the best-practice
guidelines and expedited processes, the department and the counties
may develop an expedited enrollment timeframe for newborns that is
separate from the standards for all other applications, to the extent
that the timeframe is consistent with these guidelines and
processes.
(C) Notwithstanding the rulemaking procedures of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code, the department may implement this section by
means of all-county letters or similar instructions, without further
regulatory action.
(3) Perform timely annual redeterminations, as follows:
(A) Ninety percent of the annual redetermination forms shall be
mailed to the recipient by the anniversary date.
(B) Ninety percent of the annual redeterminations shall be
completed within 60 days of the recipient's annual redetermination
date for those redeterminations based on forms that are complete and
have been returned to the county by the recipient in a timely manner.
(C) Ninety percent of those annual redeterminations where the
redetermination form has not been returned to the county by the
recipient shall be completed by sending a notice of action to the
recipient within 45 days after the date the form was due to the
county.
(D) When a child is determined by the county to change from no
share of cost to a share of cost and the child meets the eligibility
criteria for the Healthy Families Program established under Section
12693.98 of the Insurance Code, the child shall be placed in the
Medi-Cal-to-Healthy Families Bridge Benefits Program, and these cases
shall be processed as follows:
(i) Ninety percent of the families of these children shall be sent
a notice informing them of the Healthy Families Program within five
working days from the determination of a share of cost.
(ii) Ninety percent of all annual redetermination forms for these
children shall be sent to the Healthy Families Program within five
working days from the determination of a share of cost if the parent
has given consent to send this information to the Healthy Families
Program.
(iii) Ninety percent of the families of these children placed in
the Medi-Cal-to-Healthy Families Bridge Benefits Program who have not
consented to sending the child's annual redetermination form to the
Healthy Families Program shall be sent a request, within five working
days of the determination of a share of cost, to consent to send the
information to the Healthy Families Program.
(E) Subparagraph (D) shall not be implemented until 60 days after
the Medi-Cal and Joint Medi-Cal and Healthy Families applications and
the Medi-Cal redetermination forms are revised to allow the parent
of a child to consent to forward the child's information to the
Healthy Families Program.
(e) The department shall develop procedures in collaboration with
the counties and stakeholder groups for determining county review
cycles, sampling methodology and procedures, and data reporting.
(f) On January 1 of each year, each applicable county, as
determined by the department, shall report to the department on the
county's results in meeting the performance standards specified in
this section. The report shall be subject to verification by the
department. County reports shall be provided to the public upon
written request.
(g) If the department finds that a county is not in compliance
with one or more of the standards set forth in this section, the
county shall, within 60 days, submit a corrective action plan to the
department for approval. The corrective action plan shall, at a
minimum, include steps that the county shall take to improve its
performance on the standard of standards with which the county is out
of compliance. The plan shall establish interim benchmarks for
improvement that shall be expected to be met by the county in order
to avoid a sanction.
(h) If a county does not meet the performance standards for
completing eligibility determinations and redeterminations as
specified in this section, the department may, at its sole
discretion, reduce the allocation of funds to that county in the
following year by 2 percent. Any funds so reduced may be restored by
the department if, in the determination of the department, sufficient
improvement has been made by the county in meeting the performance
standards during the year for which the funds were reduced. If the
county continues not to meet the performance standards, the
department may reduce the allocation by an additional 2 percent for
each year thereafter in which sufficient improvement has not been
made to meet the performance standards.
(i) The department shall develop procedures, in collaboration with
the counties and stakeholders, for developing instructions for the
performance standards established under subparagraph (D) of paragraph
(3) of subdivision (c), no later than September 1, 2005.
(j) No later than September 1, 2005, the department shall issue a
revised annual redetermination form to allow a parent to indicate
parental consent to forward the annual redetermination form to the
Healthy Families Program if the child is determined to have a share
of cost.
(k) The department, in coordination with the Managed Risk Medical
Insurance Board, shall streamline the method of providing the Healthy
Families Program with information necessary to determine Healthy
Families eligibility for a child who is receiving services under the
Medi-Cal-to-Healthy Families Bridge Benefits Program.
SEC. 70. Section 14572 of the Welfare and Institutions Code is
amended to read:
14572. (a) No Medi-Cal reimbursement shall be made for a service
rendered by an adult day health care provider that does not have a
license as an adult day health care center or that does not have
currently effective Medi-Cal certification pursuant to this chapter.
(b) Notwithstanding subdivision (a), Medi-Cal certification shall
be granted as of the date of licensure with respect to, and
reimbursement shall be made for, a service rendered on or after that
date if the provider meets all of the following requirements:
(1) Is exempt from the moratorium imposed on the certification and
enrollment of new adult day health care centers pursuant to
paragraph (5) of subdivision (b) of Section 14043.46.
(2) Meets all certification requirements for adult day health care
centers, and is enrolled as a Medi-Cal provider.
(3) Provides services in compliance with the requirements of this
chapter as of the date the center began providing services to
beneficiaries.
SEC. 71. Section 14592 of the Welfare and Institutions Code is
amended to read:
14592. (a) The director may contract with up to ten demonstration
projects to develop risk-based long-term care pilot programs modeled
upon On Lok Senior Health Services in San Francisco. The department
shall seek necessary federal waivers for each demonstration site
pursuant to Section 1115 of the Social Security Act (42 U.S.C.A. Sec.
1315). The director shall not enter into contracts with any
demonstration program unless necessary federal waivers are obtained.
(b) The demonstration sites shall be public or private nonprofit
organizations providing or having the capacity to provide, as
determined by the director, comprehensive health care services on a
risk-based capitated basis to frail elderly persons certifiable for
institutional care. Implementation of this section shall be in
accordance with Section 4118(g)(1)(2) of the federal Omnibus Budget
Reconciliation Act of 1987.
(c) The department shall establish capitation rates paid to each
PACE organization at no less than 90 percent of the fee-for-service
equivalent cost, including the department's cost of administration,
that the department estimates would be payable for all services
covered under the PACE organization contract if all those services
were to be furnished to Medi-Cal beneficiaries under the
fee-for-service Medi-Cal program provided for pursuant to Chapter 7
(commencing with Section 14000). This subdivision shall be
implemented only to the extent that federal financial participation
is available.
SEC. 72. Section 16809 of the Welfare and Institutions Code, as
amended by Section 30 of Chapter 80 of the Statutes of 2005, is
amended to read:
16809. (a) (1) The board of supervisors of a county that
contracted with the department pursuant to Section 16709 during the
1990-91 fiscal year and any county with a population under 300,000,
as determined in accordance with the 1990 decennial census, by
adopting a resolution to that effect, may elect to participate in the
County Medical Services Program. The County Medical Services Program
shall have responsibilities for specified health services to county
residents certified eligible for those services by the county.
(2) If the County Medical Services Program Governing Board
contracts with the department to administer the County Medical
Services Program, that contract shall include, but need not be
limited to, all of the following:
(A) Provisions for the payment to participating counties for
making eligibility determinations based on the formula used by the
County Medical Services Program for the 1993-94 fiscal year.
(B) Provisions for payment of expenses of the County Medical
Services Program Governing Board.
(C) Provisions relating to the flow of funds from counties'
vehicle license fees, sales taxes, and participation fees and the
procedures to be followed if a county does not pay those funds to the
program.
(D) Those provisions, as applicable, contained in the 1993-94
fiscal year contract with counties under the County Medical Services
Program.
(3) The contract between the department and the County Medical
Services Program Governing Board shall require that the County
Medical Services Program Governing Board shall reimburse three
million five hundred thousand dollars ($3,500,000) for the state
costs of providing administrative support to the County Medical
Services Program. The department may decline to implement decisions
made by the governing board that would require a greater level of
administrative support than that for the 1993-94 fiscal year. The
department may implement decisions upon compensation by the governing
board to cover that increased level of support.
(4) The contract between the department and the County Medical
Services Program Governing Board may include provisions for the
administration of a pharmacy benefit program and, pursuant to these
provisions, the department may negotiate, on behalf of the County
Medical Services Program, rebates from manufacturers that agree to
participate. The governing board shall reimburse the department for
staff costs associated with this paragraph.
(5) The department shall administer the County Medical Services
Program pursuant to the provisions of the 1993 -94 fiscal year
contract with the counties and regulations relating to the
administration of the program until the County Medical Services
Program Governing Board executes a contract for the administration of
the County Medical Services Program and adopts regulations for that
purpose.
(6) The department shall not be liable for any costs related to
decisions of the County Medical Services Program Governing Board that
are in excess of those set forth in the contract between the
department and the County Medical Services Program Governing Board.
(b) Each county intending to participate in the County Medical
Services Program pursuant to this section shall submit to the
Governing Board of the County Medical Services Program a notice of
intent to contract adopted by the board of supervisors no later than
April 1 of the fiscal year preceding the fiscal year in which the
county will participate in the County Medical Services Program.
(c) A county participating in the County Medical Services Program
pursuant to this section shall not be relieved of its indigent health
care obligation under Section 17000.
(d) (1) The County Medical Services Program Account is established
in the County Health Services Fund. The County Medical Services
Program Account is continuously appropriated, notwithstanding Section
13340 of the Government Code, without regard to fiscal years. The
following amounts may be deposited in the account:
(A) Any interest earned upon money deposited in the account.
(B) Moneys provided by participating counties or appropriated by
the Legislature to the account.
(C) Moneys loaned pursuant to subdivision (q).
(2) The methods and procedures used to deposit funds into the
account shall be consistent with the methods used by the program
during the 1993-94 fiscal year.
(e) Moneys in the program account shall be used by the department,
pursuant to its contract with the County Medical Services Program
Governing Board, to pay for health care services provided to the
persons meeting the eligibility criteria established pursuant to
subdivision (j) and to pay for the expense of the governing board as
set forth in the contract between the board and the department. In
addition, moneys in this account may be used to reimburse the
department for state costs pursuant to paragraph (3) of subdivision
(a).
(f) (1) Moneys in this account shall be administered on an accrual
basis and notwithstanding any other provision of law, except as
provided in this section, shall not be transferred to any other fund
or account in the State Treasury except for purposes of investment as
provided in Article 4 (commencing with Section 16470) of Chapter 3
of Part 2 of Division 4 of Title 2 of the Government Code.
(2) (A) All interest or other increment resulting from the
investment shall be deposited in the program account, at the end of
the 1982-83 fiscal year and every six months thereafter,
notwithstanding Section 16305.7 of the Government Code.
(B) All interest deposited pursuant to subparagraph (A) shall be
available to reimburse program-covered services, County Medical
Services Program Governing Board expenses, or for expenditures to
augment the program's rates, benefits, or eligibility criteria
pursuant to subdivision (j).
(g) A separate County Medical Services Program Reserve Account is
established in the County Health Services Fund. Six months after the
end of each fiscal year, any projected savings in the program
account shall be transferred to the reserve account, with final
settlement occurring no more than 12 months later. Moneys in this
account shall be utilized when expenditures for health services made
pursuant to subdivision (j) for a fiscal year exceed the amount of
funds available in the program account for that fiscal year. When
funds in the reserve account are estimated to exceed 10 percent of
the budget for health services for all counties electing to
participate in the County Medical Services Program under this section
for the fiscal year, the additional funds shall be available for
expenditure to augment the rates, benefits, or eligibility criteria
pursuant to subdivision (j) or for reducing the participation fees as
determined by the County Medical Services Program Governing Board
pursuant to subdivision (i). Nothing in this section shall preclude
the CMSP Governing Board from establishing other reserves.
(h) Moneys in the program account and the reserve account, except
for moneys provided by the state in excess of the amount required to
fund the state risk specified in subdivision (j), and any funds
loaned pursuant to subdivision (q) shall not be transferred to any
other fund or account in the State Treasury except for purposes of
investment as provided in Article 4 (commencing with Section 16470)
of Chapter 3 of Part 2 of Division 4 of Title 2 of the Government
Code. All interest or other increment resulting from investment shall
be deposited in the program account, notwithstanding Section 16705.7
of the Government Code.
(i) (1) Counties shall pay participation fees as established by
the County Medical Services Program Governing Board and their
jurisdictional risk amount in a method that is consistent with that
established in the 1993-94 fiscal year.
(2) A county may request, due to financial hardship, the payments
under paragraph (1) be delayed. The request shall be subject to
approval by the CMSP Governing Board.
(3) Payments made pursuant to this subdivision shall be deposited
in the program account.
(4) Payments may be made as part of the deposits authorized by the
county pursuant to Sections 17603.05 and 17604.05.
(j) (1) (A) For the 1991-92 fiscal year and all preceding fiscal
years, the state shall be at risk for any costs in excess of the
amounts deposited in the reserve fund.
(B) (i) Beginning in the 1992-93 fiscal year and for each fiscal
year thereafter, counties and the state shall share the risk for cost
increases of the County Medical Services Program not funded through
other sources. The state shall be at risk for any cost that exceeds
the cumulative annual growth in dedicated sales tax and vehicle
license fee revenue, up to the amount of twenty million two hundred
thirty-seven thousand four hundred sixty dollars ($20,237,460) per
fiscal year, except for the 1999-2000, 2000-01, 2001-02, 2002-03,
2003-04, 2004-05, 2005-06, and 2006-07 fiscal years. Counties shall
be at risk up to the cumulative annual growth in the Local Revenue
Fund created by Section 17600, according to the table specified in
paragraph (2), to the County Medical Services Program, plus the
additional cost increases in excess of twenty million two hundred
thirty-seven thousand four hundred sixty dollars ($20,237,460) per
fiscal year, except for the 1999-2000, 2000-01, 2001-02, 2002-03,
2003-04, 2004-05, 2005-06, and 2006-07 fiscal years. In the 1994-95
fiscal year, the amount of the state risk shall be twenty million two
hundred thirty-seven thousand four hundred sixty dollars
($20,237,460) per fiscal year, in addition to the cost of
administrative support pursuant to paragraph (3) of subdivision (a).
(ii) For the 1999-2000, 2000-01, 2001-02, 2002-03, 2003-04,
2004-05, 2005-06, and 2006-07 fiscal years, the state shall not be at
risk for any cost that exceeds the cumulative annual growth in
dedicated sales tax and vehicle license fee revenue. Counties shall
be at risk up to the cumulative annual growth in the Local Revenue
Fund created by Section 17600, according to the table specified in
paragraph (2), to the County Medical Services Program, plus any
additional cost increases for the 1999-2000, 2000-01, 2001-02,
2002-03, 2003-04, 2004 -05, 2005-06, and 2006-07 fiscal years.
(C) The CMSP Governing Board, after consultation with the
department, shall establish uniform eligibility criteria and benefits
for the County Medical Services Program.
(2) For the 1991-92 fiscal year, jurisdictional risk limitations
shall be as follows:
Jurisdiction Amount
Alpine.......................... $ 13,150
Amador.......................... 620,264
Butte........................... 5,950,593
Calaveras....................... 913,959
Colusa.......................... 799,988
Del Norte....................... 781,358
El Dorado....................... 3,535,288
Glenn........................... 787,933
Humboldt........................ 6,883,182
Imperial........................ 6,394,422
Inyo............................ 1,100,257
Kings........................... 2,832,833
Lassen.......................... 687,113
Madera.......................... 2,882,147
Marin........................... 7,725,909
Mariposa........................ 435,062
Modoc........................... 469,034
Mono............................ 369,309
Napa............................ 3,062,967
Nevada.......................... 1,860,793
Plumas.......................... 905,192
San Benito...................... 1,086,011
Shasta.......................... 5,361,013
Sierra.......................... 135,888
Siskiyou........................ 1,372,034
Solano.......................... 6,871,127
Sonoma.......................... 13,183,359
Sutter.......................... 2,996,118
Tehama.......................... 1,912,299
Trinity......................... 611,497
Tuolumne........................ 1,455,320
Yuba............................ 2,395,580
(3) Beginning in the 1991-92 fiscal year and in subsequent fiscal
years, the jurisdictional risk limitation for the counties that did
not contract with the department pursuant to Section 16709 during the
1990-91 fiscal year shall be the amount specified in paragraph (A)
plus the amount determined pursuant to paragraph (B), minus the
amount specified by the County Medical Services Program Governing
Board as participation fees.
(A)
Jurisdiction Amount
Lake........................... $1,022,963
Mendocino...................... 1,654,999
Merced......................... 2,033,729
Placer......................... 1,338,330
San Luis Obispo................ 2,000,491
Santa Cruz..................... 3,037,783
Yolo........................... 1,475,620
(B) The amount of funds necessary to fully fund the anticipated
costs for the county shall be determined by the CMSP Governing Board
before a county is permitted to participate in the County Medical
Services Program.
(4) For the 1994-95 and 1995-96 fiscal years, the specific amounts
and method of apportioning risk to each participating county may be
adjusted by the CMSP Governing Board.
(k) The Legislature hereby determines that an expedited contract
process for contracts under this section is necessary. Contracts
under this section shall be exempt from Part 2 (commencing with
Section 10100) of Division 2 of the Public Contract Code. Contracts
of the department pursuant to this section shall have no force or
effect unless they are approved by the Department of Finance.
(l) The state shall not incur any liability except as specified in
this section.
(m) Third-party recoveries for services provided under this
section pursuant to Article 3.5 (commencing with Section 14124.70) of
Chapter 7 of Part 3 may be pursued.
(n) Under the program provided for in this section, the department
may reimburse hospitals for inpatient services at the rates
negotiated for the Medi-Cal program by the California Medical
Assistance Commission, pursuant to Article 2.6 (commencing with
Section 14081) of Chapter 7 of Part 3, if the California Medical
Assistance Commission determines that reimbursement to the hospital
at the contracted rate will not have a detrimental fiscal impact on
either the Medi-Cal program or the program provided for in this
section. In negotiating and renegotiating contracts with hospitals,
the commission may seek terms which allow reimbursement for patients
receiving services under this section at contracted Medi-Cal rates.
(o) Any hospital which has a contract with the state for inpatient
services under the Medi-Cal program and which has been approved by
the commission to be reimbursed for patients receiving services under
this section shall not deny services to these patients.
(p) Participating counties may conduct an independent program
review to identify ways through which program savings may be
generated. The counties and the department may collectively pursue
identified options for the realization of program savings.
(q) The Department of Finance may authorize a loan of up to thirty
million dollars ($30,000,000) for deposit into the program account
to ensure that there are sufficient funds available to reimburse
providers and counties pursuant to this section.
(r) Regulations adopted by the department pursuant to this section
shall remain operative and shall be used to operate the County
Medical Services Program until a contract with the County Medical
Services Program Governing Board is executed and regulations, as
appropriate, are adopted by the County Medical Services Program
Governing Board. Notwithstanding Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code, those regulations adopted under the County Medical Services
Program shall become inoperative until January 1, 1998, except those
regulations that the department, in consultation with the County
Medical Services Program Governing Board, determines are needed to
continue to administer the County Medical Services Program. The
department shall notify the Office of Administrative Law as to those
regulations the department will continue to use in the implementation
of the County Medical Services Program.
(s) Moneys appropriated from the General Fund to meet the state
risk as set forth in subparagraph (B) of paragraph (1) of subdivision
(j) shall not be available for those counties electing to disenroll
from the County Medical Services Program.
(t) This section shall remain in effect only until January 1,
2008, and as of that date is repealed, unless a later enacted
statute, that is enacted on or before January 1, 2008, deletes or
extends that date.
SEC. 73. Section 16809 of the Welfare and Institutions Code, as
amended by Section 31 of Chapter 80 of the Statutes of 2005, is
amended to read:
16809. (a) The board of supervisors of a county that contracted
with the department pursuant to Section 16709 during the 1990-91
fiscal year and any county with a population under 300,000, as
determined in accordance with the 1990 decennial census, may enter
into a contract with the department and the department may enter into
a contract with that county under which the department agrees to
administer the program responsibilities for specified health services
to county residents certified eligible for those services by the
county.
(b) Each county intending to contract with the department pursuant
to this section shall submit to the department a notice of intent to
contract adopted by the board of supervisors no later than April 1
of the fiscal year preceding the fiscal year for which the agreement
will be in effect in accordance with procedures established by the
department.
(c) A county contracting with the department pursuant to this
section shall not be relieved of its indigent health care obligation
under Section 17000.
(d) The department shall establish the County Medical Services
Program Account in the County Health Services Fund. The County
Medical Services Program Account is continuously appropriated,
notwithstanding Section 13340 of the Government Code, without regard
to fiscal years. The following amounts may be deposited in the
account:
(1) Any interest earned upon money deposited in the account.
(2) Moneys provided by participating counties or appropriated by
the Legislature to the account.
(3) Moneys loaned pursuant to subdivision (q).
(e) Moneys in the program account shall be used by the department
to pay for health care services provided to the persons meeting the
eligibility criteria established pursuant to subdivision (j).
(f) (1) Moneys in this account shall be administered on an accrual
basis and notwithstanding any other provision of law, except as
provided in this section, shall not be transferred to any other fund
or account in the State Treasury except for purposes of investment as
provided in Article 4 (commencing with Section 16470) of Chapter 3
of Part 2 of Division 4 of Title 2 of the Government Code.
(2) (A) All interest or other increment resulting from the
investment shall be deposited in the program account, at the end of
the 1982-83 fiscal year and every six months thereafter,
notwithstanding Section 16305.7 of the Government Code.
(B) All interest deposited pursuant to subparagraph (A) shall be
available to reimburse program-covered services, or for expenditures
to augment the program's rates, benefits, or eligibility criteria
pursuant to subdivision (j).
(g) The department shall establish a separate County Medical
Services Program Reserve Account in the County Health Services Fund.
Six months after the end of each fiscal year, any projected savings
in the program account shall be transferred to the reserve account,
with final settlement occurring no more than 12 months later. Moneys
in this account shall be utilized when expenditures for health
services made pursuant to subdivision (j) for a fiscal year exceed
the amount of funds available in the program account for that fiscal
year. When funds in the reserve account are estimated to exceed 10
percent of the budget for health services for all counties electing
to contract with the department under this section for the fiscal
year, the additional funds shall be available for expenditure to
augment the rates, benefits, or eligibility criteria pursuant to
subdivision (j) or for reducing the participation fees required by
Section 16809.3.
(h) Moneys in the program account and the reserve account, except
for moneys provided by the state in excess of the amount required to
fund the state risk specified in subdivision (j), and any funds
loaned pursuant to subdivision (q), shall not be transferred to any
other fund or account in the State Treasury except for purposes of
investment as provided in Article 4 (commencing with Section 16470)
of Chapter 3 of Part 2 of Division 4 of Title 2 of the Government
Code. All interest or other increment resulting from investment shall
be deposited in the program account, notwithstanding Section 16705.7
of the Government Code.
(i) (1) Counties shall pay by the 15th of each month the
agreed-upon contract amount. In the event a county does not make the
agreed-upon monthly payment, the department may terminate the county'
s participation in the program.
(2) A county may request, due to financial hardship, the payments
under paragraph (1) be delayed. The request shall be subject to
approval by the Small County Advisory Committee.
(3) Payments made pursuant to this subdivision shall be deposited
in the program account.
(4) Payments may be made as part of the deposits authorized by the
county pursuant to Sections 17603.05 and 17604.05.
(j) (1) (A) For the 1991-92 fiscal year and all preceding fiscal
years, the state shall be at risk for any costs in excess of the
amounts deposited in the reserve fund.
(B) Beginning in the 1992-93 fiscal year and for each fiscal year
thereafter, counties and the state shall share the risk for cost
increases of the County Medical Services Program not funded through
other sources. The state shall be at risk for any cost that exceeds
the cumulative annual growth in dedicated sales tax and vehicle
license fee revenue, up to the amount of twenty million two hundred
thirty-seven thousand four hundred sixty dollars ($20,237,460) per
fiscal year, except for the 1999-2000, 2000-01, 2001-02, 2002-03,
2003-04, 2004-05, 2005-06, and 2006-07 fiscal years. Counties shall
be at risk up to the cumulative annual growth in the Local Revenue
Fund created by Section 17600 according to the table specified in
paragraph (2) to the County Medical Services Program, plus additional
cost increases in excess of twenty million two hundred thirty-seven
thousand four hundred sixty dollars ($20,237,460) per fiscal year.
(C) As a condition of the state assuming this risk, the department
may require uniform eligibility criteria and benefits to be provided
which shall be mutually established by participating counties in
conjunction with the department. The County Medical Services Program
Governing Board may revise these eligibility criteria and benefits or
alter rates of payment in order to assure that expenditures do not
exceed the funds available in the program account.
(2) For the 1991-92 fiscal year, jurisdictional risk limitations
shall be as follows:
Jurisdiction Amount
Alpine.......................... $ 13,150
Amador.......................... 620,264
Butte........................... 5,950,593
Calaveras....................... 913,959
Colusa.......................... 799,988
Del Norte....................... 781,358
El Dorado....................... 3,535,288
Glenn........................... 787,933
Humboldt........................ 6,883,182
Imperial........................ 6,394,422
Inyo............................ 1,100,257
Kings........................... 2,832,833
Lassen.......................... 687,113
Madera.......................... 2,882,147
Marin........................... 7,725,909
Mariposa........................ 435,062
Modoc........................... 469,034
Mono............................ 369,309
Napa............................ 3,062,967
Nevada.......................... 1,860,793
Plumas.......................... 905,192
San Benito...................... 1,086,011
Shasta.......................... 5,361,013
Sierra.......................... 135,888
Siskiyou........................ 1,372,034
Solano.......................... 6,871,127
Sonoma.......................... 13,183,359
Sutter.......................... 2,996,118
Tehama.......................... 1,912,299
Trinity......................... 611,497
Tuolumne........................ 1,455,320
Yuba............................ 2,395,580
(3) Beginning in the 1991-92 fiscal year and in subsequent fiscal
years, the jurisdictional risk limitation for the counties that did
not contract with the department pursuant to Section 16709 during the
1990-91 fiscal year shall be the amount specified in paragraph (A)
plus the amount determined pursuant to paragraph (B), minus the
amount specified in Section 16809.3.
(A)
Jurisdiction Amount
Lake............................. 1,022,963
Mendocino........................ 1,654,999
Merced........................... 2,033,729
Placer........................... 1,338,330
San Luis Obispo.................. 2,000,491
Santa Cruz....................... 3,037,783
Yolo............................. 1,475,620
(B) The amount of funds necessary to fully fund the anticipated
costs for the county shall be determined by the department. This
amount shall be subject to the approval of both the Department of
Finance and the Small County Advisory Committee before a county is
permitted to contract back with the department.
(4) For the 1992-93 fiscal year and fiscal years thereafter, the
amounts of the jurisdictional risk limitations shall be adjusted
according to the provisions of paragraph (2).
(k) The Legislature hereby determines that an expedited contract
process for contracts under this section is necessary. Contracts
under this section shall be exempt from the provisions of Chapter 2
(commencing with Section 10290) of Part 2 of Division 2 of the Public
Contract Code. Contracts shall have no force and effect unless
approved by the Department of Finance.
(l) The state shall not incur any liability except as specified in
this section.
(m) The department may pursue third-party recoveries for services
provided under this section pursuant to Article 3.5 (commencing with
Section 14124.70) of Chapter 7 of Part 3.
(n) Under the program provided for in this section, the department
shall reimburse hospitals for inpatient services at the rates
negotiated for the Medi-Cal program by the California Medical
Assistance Commission, pursuant to Article 2.6 (commencing with
Section 14081) of Chapter 7 of Part 3, if the California Medical
Assistance Commission determines that reimbursement to the hospital
at the contracted rate will not have a detrimental fiscal impact on
either the Medi-Cal program or the program provided for in this
section. In negotiating and renegotiating contracts with hospitals,
the commission may seek terms which allow reimbursement for patients
receiving services under this section at contracted Medi-Cal rates.
(o) Any hospital which has a contract with the state for inpatient
services under the Medi-Cal program and which has been approved by
the commission to be reimbursed for patients receiving services under
this section shall not deny services to these patients.
(p) Participating counties may conduct an independent program
review to identify ways through which program savings may be
generated. The counties and the department shall collectively pursue
identified options for the realization of program savings.
(q) The Department of Finance may authorize a loan of up to thirty
million dollars ($30,000,000) for deposit into the program account
to ensure that there are sufficient funds available to reimburse
providers and counties pursuant to this section.
(r) This section shall become operative January 1, 2008.
SEC. 74. In response to a signed consent decree between the United
States Department of Justice, Civil Rights Division, and the state
pursuant to the Civil Rights of Institutionalized Persons Act (42
U.S.C. Sec. 1997 and following), the State Department of Mental
Health shall, commencing in September 2006, and every three months
thereafter until the state is in compliance with the consent decree,
provide to the appropriate fiscal and policy committees of the
Legislature all of the following:
(a) Copies of all monitoring reports produced within the previous
six months by the court monitor jointly appointed by the state and
the United States Department of Justice. All reports regarding
Metropolitan State Hospital shall be included within these monitoring
reports.
(b) Copies of other correspondence between the United States
Department of Justice, the court monitor, and the State Department of
Mental Health regarding compliance with the consent decree.
SEC. 75. The adoption and one readoption of regulations to
implement the amendment of Sections 12693.70, 12696.05, and 12699 of
the Insurance Code, and the addition of Section 12695.03 to the
Insurance Code, by this act, and to implement enhancements to
application assistance payments pursuant to Section 12693.32 of the
Insurance Code, shall be deemed to be an emergency and necessary for
the immediate preservation of public peace, health and safety, or
general welfare for purposes of Sections 11346.1 and 11349.6 of the
Government Code, and the Managed Risk Medical Insurance Board is
hereby exempted from the requirements that it describe specific facts
showing the need for immediate action and from review by the Office
of Administrative Law. For purposes of subdivision (e) of Section
11346.1 of the Government Code, the 120-day period, as applicable to
the effective period of an emergency regulation and submission of
specified materials to the Office of Administrative Law, is hereby
extended to 180 days.
SEC. 76. The Managed Risk Medical Insurance Board shall provide
the chairs of the appropriate fiscal and policy committees of the
Legislature with copies of each of the individual phases of the
evaluation being conducted regarding the Healthy Families Program and
the provision of mental health and substance abuse treatment
services. These copies shall be provided on a flow basis as
appropriate when completed by the contractor.
SEC. 77. (a) The Legislature hereby refers an audit request to the
Bureau of State Audits to conduct an audit during the 2007-08 fiscal
year of the clinical laboratory oversight programs of the State
Department of Health Services to assess the department's practices
and procedures for enforcing state laws and regulations regarding the
licensing, certification, and registration of clinical laboratories.
This audit request shall be considered by the Bureau of State Audits
within its overall audit requests.
(b) Any audit conducted pursuant to subdivision (a) shall include,
but not be limited to, the following:
(1) A review of the extent and effectiveness of the department's
practices and procedures regarding each of the following:
(A) Detecting and determining when clinical laboratories are not
in compliance with applicable state laws and regulations.
(B) Investigating cases of possible noncompliance, including, in
particular, the investigation of consumer complaints filed with the
department against clinical laboratories.
(C) Imposing appropriate sanctions on clinical laboratories that
are found not to have complied with state laws and regulations. The
audit shall review, in particular, the frequency and extent of the
department's use of its existing authority to assess and collect
civil fines, refer violators for criminal prosecution, and bar
participation from state and federally funded health programs, and
its use of any other means available to enforce state law and
regulations regarding clinical laboratories.
(2) Recommendations, if any, for improving state oversight of
clinical laboratories.
(c) The results of any audit conducted pursuant to subdivision (a)
shall be reported to the chair of the Joint Legislative Budget
Committee, and the chairs of the fiscal committees, health policy
committees, and the business and professions committees of both
houses of the Legislature.
SEC. 78. (a) Of the funds appropriated in Item 4260-111-0001 of
Section 2.00 of the Budget Act of 2006 from the Cigarette and Tobacco
Products Surtax Fund, twenty-four million eight hundred three
thousand dollars ($24,803,000) shall be allocated in accordance with
subdivision (b) for the 2006-07 fiscal year from the following
accounts:
(1) Twenty million two hundred twenty-seven thousand dollars
($20,227,000) from the Hospital Services Account.
(2) Four million five hundred seventy-six thousand dollars
($4,576,000) from the Physician Services Account.
(b) The funds specified in subdivision (a) shall be allocated
proportionately as follows:
(1) Twenty-two million three hundred twenty-four thousand dollars
($22,324,000) shall be administered and allocated for distribution
through the California Healthcare for Indigents Program (CHIP),
Chapter 5 (commencing with Section 16940) of Part 4.7 of Division 9
of the Welfare and Institutions Code.
(2) Two million four hundred seventy-nine thousand dollars
($2,479,000) shall be administered and allocated through the rural
health services program, Chapter 4 (commencing with Section 16930) of
Part 4.7 of Division 9 of the Welfare and Institutions Code.
(c) Funds allocated pursuant to this section from the Physician
Services Account and the Hospital Services Account in the Cigarette
and Tobacco Products Surtax Fund shall be used only for the
reimbursement of physicians for losses incurred in providing
uncompensated emergency services in general acute care hospitals
providing basic, comprehensive, or standby emergency services, as
defined in Section 16953 of the Welfare and Institutions Code. Funds
shall be transferred to the Physician Services Account in the county
Emergency Medical Services Fund established pursuant to Sections
16951 and 16952 of the Welfare and Institutions Code, and shall be
paid only to physicians who directly provide emergency medical
services to patients, based on claims submitted or a subsequent
reconciliation of claims. Payments shall be made as provided in
Sections 16951 to 16959, inclusive, of the Welfare and Institutions
Code, and payments shall be made on an equitable basis, without
preference to any particular physician or group of physicians.
SEC. 79. The State Department of Mental Health shall revise its
method for auditing entities that provide specialty mental health
services under the Early and Periodic Screening, Diagnosis, and
Treatment Program, and its method for extrapolating data obtained
from those audits, pursuant to this section. Commencing July 1, 2006,
and continuing thereafter, the following provisions shall apply:
(a) The department shall select statistically valid stratified
samples by service function for each entity to be audited.
(b) The department shall not extrapolate the results of any audit
to the full audited service function unless the error rate determined
by the audit is 5 percent or greater. If the error rate is less than
5 percent, the department shall disallow only the specific claims
found to be in error.
(c) The department, in consultation with stakeholders, shall
select an independent statistician to review the sampling methodology
and extrapolation methodology used by the department. No later than
October 1, 2006, the statistician shall prepare a public report on
the statistical validity of those methodologies. If the statistician
determines either methodology to be invalid, the department shall
adopt a new methodology, which shall be used by the department only
after its validity is verified by the statistician.
SEC. 80. (a) Commencing on the date that the Budget Act of 2006 is
enacted, funds provided to county mental health departments from
Item 6110-161-0890 and Item 4440-104-0001 of the Budget Act of 2006
for services provided pursuant to Chapter 26.5 (commencing with
Section 7570) of Division 7 of Title 1 of the Government Code shall
be timely. Those funds shall be used exclusively to provide
state-mandated services pursuant to that chapter, and counties shall
identify those funds as provided for this purpose in any future claim
for state-mandated reimbursement for services provided pursuant to
that chapter.
(1) The State Department of Education shall be responsible for the
timely distribution of funds appropriated in Item 6110-161-0890 to
county offices of education. These funds shall be distributed
consistent with an allocation plan formulated by the State Department
of Mental Health in consultation with representatives of county
mental health departments. The timing of distributions shall meet the
following requirements:
(A) A minimum of 50 percent of the appropriated funds shall be
provided to county mental health departments through the county
offices of education by January 1 of each year.
(B) A minimum of 75 percent of the appropriated funds shall be
provided to county mental health departments through the county
offices of education by March 1 of each year.
(2) The funds appropriated in Item 4440-104-0001 shall be
distributed consistent with an allocation plan formulated by the
State Department of Mental
Health in consultation with representatives of county mental health
departments.
(A) The State Department of Mental Health shall make monthly
payments of one-twelfth of 95 percent of the funds appropriated in
Item 4440-104-0001 of the Budget Act of 2006 to county mental health
departments. The remaining 5 percent shall be allocated upon
completion of the settle-up pursuant to paragraph (3).
(B) Commencing in the 2007-08 fiscal year, the State Department of
Mental Health shall make monthly payments of the funds appropriated
in Item 4440-104-0001 of the annual Budget Act to county mental
health departments with adopted memoranda of understanding as
required in subdivision (b). The remaining 5 percent shall be
allocated upon completion of the settle-up pursuant to paragraph (3).
(3) The State Department of Mental Health shall settle payments to
actual allowable costs up to the amount available in Item
4440-104-0001 of the annual Budget Act.
(4) Any additional allowable costs incurred by a county mental
health department for services required pursuant to Chapter 26.5
(commencing with Section 7570) of Division 7 of Title 1 of the
Government Code shall be reimbursed through the state mandate claims
process.
(b) (1) Commencing in the 2007-08 fiscal year, as a condition of
receiving funds appropriated in Item 4440-104-0001 of the annual
Budget Act for mental health services for students with
individualized education plans pursuant to Chapter 26.5 (commencing
with Section 7570) of Division 7 of Title 1 of the Government Code, a
county mental health department and the appropriate county office of
education, or a single entity designated by the county office of
education, shall enter into a memorandum of understanding.
(2) The State Department of Mental Health shall develop a template
of the memorandum of understanding by October 1, 2006, for use by
county mental health departments and county offices of education or
their designees. This template shall be developed in collaboration
with the State Department of Education and in consultation with
county mental health departments and county offices of education. The
template for the memorandum of understanding shall contain at a
minimum the following elements:
(A) The requirements of Chapter 26.5 (commencing with Section
7570) of Division 7 of Title 1 of the Government Code in the areas of
referrals, data collection, and reporting, including, but not
limited to, the recommendations made pursuant to Paragraph (3) of
subdivision (b) of Section 56139 of the Education Code and paragraph
(1) of subdivision (b) of Section 7576.2 of the Government Code.
(B) Data required to be reported by county mental health
departments to county offices of education to meet federal reporting
requirements under the federal Individuals With Disabilities
Education Act.
(C) A description of the array of services to be delivered
consistent with assessments and individualized education plans.
(3) The State Department of Mental Health shall submit the
template to the Legislature by October 2, 2006. If the template is
not completed by October 1, 2006, the State Department of Mental
Health and the State Department of Education shall each report to the
Legislature on the status of the template and the reasons for not
meeting the October 1, 2006, deadline.
(c) The memoranda of understanding shall be adopted by county
mental health departments and county offices of education or their
designees no later than May 1, 2007.
(d) The memoranda of understanding shall be submitted to the State
Department of Mental Health by county mental health departments and
to the State Department of Education by county offices of education
or their designees within 15 days after adoption.
(e) (1) The State Department of Mental Health and the State
Department of Education shall, by May 1, 2007, collaboratively
develop claiming instructions for the appropriations in Items
6110-161-0890 and 4440-104-0001 for county mental health departments.
The claiming instructions shall be for use in the 2007-08 fiscal
year, and subsequent fiscal years. The State Department of Mental
Health shall have primary responsibility for developing instructions
for the General Fund, and the State Department of Education shall
have primary responsibility for developing instructions for funds
provided pursuant to the federal Individuals With Disabilities
Education Act. The State Department of Mental Health and the State
Department of Education shall consult with county mental health
departments and county offices of education in the development of
those instructions.
(2) The principles to be used in developing the claiming
instructions shall be to maximize the appropriate use of federal
funds and to use federal funds first.
(3) County mental health departments shall submit claims to county
offices of education on a timely basis.
(f) (1) Monitoring of county offices of education and their
designees, and county mental health departments, shall be consistent
with subdivision (a) of Section 56139 of the Education Code, and
subdivision (a) of Section 7576.2 of the Government Code.
(2) The State Department of Mental Health and the State Department
of Education shall monitor for timely memoranda of understanding.
(3) The State Department of Mental Health may monitor treatment
appropriateness to achieve educational goals as outlined in the
individualized education plans.
(4) The State Department of Mental Health may audit costs of
claims from county mental health programs for services provided
pursuant to Chapter 26.5 (commencing with Section 7570) of Division 7
of Title 1 of the Government Code. The department may also monitor
the cost of claims to determine whether they are based on actual
costs for cost-efficient services with rates comparable to similar
services funded by other state programs.
(5) The State Department of Education may monitor compliance with
individualized education plans and the timeliness of payments from
county offices of education to county mental health departments.
SEC. 81. (a) The State Department of Health Services shall provide
to the fiscal committees of the Legislature, by no later than March
15, 2007, all of the following information regarding the
reimbursement rates paid under the Medi-Cal program:
(1) Where applicable, a percent comparison regarding the
reimbursement rates paid under Medi-Cal as compared to the
reimbursement rates paid under the federal Medicare Program,
excluding rates applicable to dental services, pharmacy,
federally-qualified health centers, rural health clinics, and health
facilities.
(2) Where applicable, an estimate of the cost for increasing all
Medi-Cal reimbursement rates that are comparable to the federal
Medicare Program rates, up to a minimum of 50 percent of the rate
paid under the federal Medicare Program. The estimate shall take into
account increases necessary to keep managed care rates comparable.
(3) For those procedures reimbursed only under the Medi-Cal
program, excluding dental services, a prioritized listing of services
and procedure codes, as determined by the department, that may merit
adjustment based on a review by the department or a contractor. The
estimates shall take into account increases necessary to keep managed
care rates comparable.
(b) The department may utilize up to three hundred thousand
dollars ($300,000) of funds appropriated in Item 4260-101-0001 and
three hundred thousand dollars ($300,000) of funds appropriated in
Item 4260-101-0890 of the Budget Act of 2006 for the purposes
specified in subdivision (a), and may amend existing contracts to
expedite any necessary data collection or data analysis.
SEC. 82. (a) The Legislature, in acknowledgment that planning for
a disaster is critical to protect the citizens of the State of
California, authorizes the California Health and Human Services
Agency to implement a plan to improve the state's ability to respond
to a public health emergency. Given the magnitude and importance of
this effort, the Legislature requires frequent updates. Consequently,
the California Health and Human Services Agency, in consultation
with the Office of Emergency Services, shall report, on a quarterly
basis commencing October 1, 2006, to the appropriate fiscal and
policy committees of the Legislature, on the state's progress. The
report shall provide an update on the acquisition of disaster
preparedness equipment and supplies, including ventilators, masks,
mobile field hospitals, alternate care sites, and antivirals. The
report shall also describe the effect these efforts have had on the
state's ability to respond in the event of a public health disaster.
(b) By no later than November 15, 2006, the California Health and
Human Services Agency shall provide to the appropriate fiscal and
policy committees of the Legislature the state's plan for the new
health care delivery response system in the event of a disaster.
SEC. 83. If the Commission on State Mandates determines that this
act contains costs mandated by the state, reimbursement to local
agencies and school districts for those costs shall be made pursuant
to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of
the Government Code.
SEC. 84. This act is an urgency statute necessary for the
immediate preservation of the public peace, health, or safety within
the meaning of Article IV of the Constitution and shall go into
immediate effect. The facts constituting the necessity are:
In order to make the necessary statutory changes to implement the
Budget Act of 2006 at the earliest possible time, it is necessary
that this act take effect immediately.